TY  - JOUR
AU  - Hüttner, Felix J
AU  - Klotz, Rosa
AU  - Giese, Nathalia A
AU  - Kong, Bo
AU  - Ahmed, Azaz
AU  - Merz, Daniela
AU  - Pöchmann, Alexandra
AU  - Burghaus, Ina
AU  - Hackert, Thilo
AU  - Strobel, Oliver
AU  - Mihaljevic, André L
AU  - Michalski, Christoph W
AU  - Büchler, Markus W
AU  - Diener, Markus K
TI  - Pancreatic resection with perioperative drug repurposing of propranolol and etodolac - the phase II randomized controlled PROSPER trial.
JO  - Langenbeck's archives of surgery
VL  - 410
IS  - 1
SN  - 0023-8236
CY  - Heidelberg
PB  - Springer
M1  - DKFZ-2025-01068
SP  - 168
PY  - 2025
AB  - The perioperative period is characterized by psychological stress and inflammatory reactions that can contribute to disease recurrence or metastatic spread. These reactions are mediated particularly by catecholamines and prostaglandins. The PROSPER trial aimed to evaluate whether a perioperative drug repurposing with a non-selective betablocker (propranolol) and a COX-2 inhibitor (etodolac) is feasible and safe in the setting of pancreatic cancer surgery.Patients undergoing partial pancreatoduodenectomy for pancreatic cancer were randomized to perioperative treatment with propranolol and etodolac or placebo. Main safety endpoint was the rate of serious adverse events (SAE) and the main feasibility endpoint was adherence. Overall and disease-free survival (DFS) as well as recurrences were assessed as efficacy parameters and the trial was accompanied by a translational study.The trial was prematurely closed due to slow recruitment. 26 patients were randomized, but 6 never started trial medication. Finally, 9 patients received the trial medication and 11 patients placebo. There were 6 SAE in the treatment vs. 14 in the placebo group. Adherence was lower in the treatment group, but without statistically significance. Median DFS was 16.36 months (95
KW  - Humans
KW  - Male
KW  - Female
KW  - Middle Aged
KW  - Pancreatic Neoplasms: surgery
KW  - Pancreatic Neoplasms: mortality
KW  - Pancreatic Neoplasms: pathology
KW  - Pancreatic Neoplasms: drug therapy
KW  - Etodolac: therapeutic use
KW  - Drug Repositioning
KW  - Aged
KW  - Propranolol: therapeutic use
KW  - Pancreaticoduodenectomy
KW  - Cyclooxygenase 2 Inhibitors: therapeutic use
KW  - Adrenergic beta-Antagonists: therapeutic use
KW  - Perioperative Care: methods
KW  - Betablockade (Other)
KW  - COX-2-inhibition (Other)
KW  - Inflammation (Other)
KW  - Pancreatic cancer (Other)
KW  - Perioperative period (Other)
KW  - Etodolac (NLM Chemicals)
KW  - Propranolol (NLM Chemicals)
KW  - Cyclooxygenase 2 Inhibitors (NLM Chemicals)
KW  - Adrenergic beta-Antagonists (NLM Chemicals)
LB  - PUB:(DE-HGF)16
C6  - pmid:40402347
DO  - DOI:10.1007/s00423-025-03735-3
UR  - https://inrepo02.dkfz.de/record/301547
ER  -