Stromal deposition can become a physical and biological barrier that prevents chemotherapy from reaching pancreatic ductal adenocarcinoma (PDAC). In this study, 34 patients were treated with LDE225, which specifically targets tumour stroma, gemcitabine and nab-paclitaxel. Pancreatic tumour response was assessed using intravoxel incoherent motion (IVIM) MRI. We found that the diffusion in PDAC increased after chemotherapy, which may be explained by reduction of stroma or tumour necrosis. Furthermore, a positive correlation was found between overall survival and the change in tumour perfusion, underlining the fact that reperfusion of PDAC by LDE225 improves prognosis.
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