Selective Plasma Adsorption of Extracellular DNA in Prevention of Intraoperative Metastasis in Pancreatic Cancer (Pilot Study)

The goal of this clinical trial is to learn if selective plasma adsorption of extracellular DNA works to prevent formation of metastases of pancreatic cancer during surgical removal of the tumor. It will also help researchers to learn about the safety of selective plasma adsorption of extracellular DNA during the surgery. The main questions it aims to answer are: * Does selective plasma adsorption of extracellular DNA improve the survival of participants after surgical removal of pancreatic cancer? * Does selective plasma adsorption of extracellular DNA reduce the risk of the recurrence of pancreatic cancer? * What medical problems do participants have when they receive selective plasma adsorption of extracellular DNA during surgical removal of pancreatic cancer? Researchers will compare clinical data of participants who had selective plasma adsorption of extracellular DNA and those who did not to see if there are any differences in their health. Participants who are scheduled for surgical removal of pancreatic cancer by their doctor according to medical indications will: * Either receive selective plasma adsorption of extracellular DNA during surgical removal of pancreatic cancer and on the next day after the surgery, or not. * Do blood tests prior to surgery, during the surgery, on the next day after the surgery, one week after the surgery, 3, 6, 9, and 12 months after the surgery. * Do computed tomography scans 3, 6, 9, and 12 months after the surgery. Participants will receive selective plasma adsorption of extracellular DNA, blood tests, and computed tomography scans for free.

Sex

All

Minimum age

18 Years

Maximum age

75 Years

Inclusion Criteria:

\- Histologically and/or radiologically proven diagnosis of "Non-metastatic pancreatic ductal adenocarcinoma" of any localization, with ECOG physical status 0-1, who are scheduled for surgery for radical removal of the tumor, without previous chemotherapy (stage cT0-4 N0-2 M0) or after neoadjuvant chemotherapy (stage ycT0-4 N0-2 M0).

Exclusion Criteria:

* Presence of other known oncological diseases.
* General contraindication to plasma adsorption (hypoproteinemia; acute cardiovascular failure; intolerance to foreign protein; decreased (less than 90/60 mm Hg) arterial pressure; gastrointestinal bleeding; acute cerebrovascular accidents; acute anemia; severe hypoxia).

• BACKGROUNDZhu T, Zou X, Yang C, Li L, Wang B, Li R, Li H, Xu Z, Huang D, Wu Q. Neutrophil extracellular traps promote gastric cancer metastasis by inducing epithelial-mesenchymal transition. Int J Mol Med. 2021 Jul;48(1):127. doi: 10.3892/ijmm.2021.4960. Epub 2021 May 20. PMID 34013374
• BACKGROUNDZhang L, Jin R, Yang X, Ying D. A population-based study of synchronous distant metastases and prognosis in patients with PDAC at initial diagnosis. Front Oncol. 2023 Jan 26;13:1087700. doi: 10.3389/fonc.2023.1087700. eCollection 2023. PMID 36776324
• BACKGROUNDYang LY, Luo Q, Lu L, Zhu WW, Sun HT, Wei R, Lin ZF, Wang XY, Wang CQ, Lu M, Jia HL, Chen JH, Zhang JB, Qin LX. Increased neutrophil extracellular traps promote metastasis potential of hepatocellular carcinoma via provoking tumorous inflammatory response. J Hematol Oncol. 2020 Jan 6;13(1):3. doi: 10.1186/s13045-019-0836-0. PMID 31907001
• BACKGROUNDYang D, Liu J. Neutrophil Extracellular Traps: A New Player in Cancer Metastasis and Therapeutic Target. J Exp Clin Cancer Res. 2021 Jul 16;40(1):233. doi: 10.1186/s13046-021-02013-6. PMID 34271947
• BACKGROUNDWculek SK, Malanchi I. Neutrophils support lung colonization of metastasis-initiating breast cancer cells. Nature. 2015 Dec 17;528(7582):413-7. doi: 10.1038/nature16140. Epub 2015 Dec 9. PMID 26649828
• BACKGROUNDWang H, Zhang H, Wang Y, Brown ZJ, Xia Y, Huang Z, Shen C, Hu Z, Beane J, Ansa-Addo EA, Huang H, Tian D, Tsung A. Regulatory T-cell and neutrophil extracellular trap interaction contributes to carcinogenesis in non-alcoholic steatohepatitis. J Hepatol. 2021 Dec;75(6):1271-1283. doi: 10.1016/j.jhep.2021.07.032. Epub 2021 Aug 4. PMID 34363921
• BACKGROUNDVentriglia J, Petrillo A, Huerta Alvaro M, Laterza MM, Savastano B, Gambardella V, Tirino G, Pompella L, Diana A, Iovino F, Troiani T, Martinelli E, Morgillo F, Orditura M, Cervantes A, Ciardiello F, De Vita F. Neutrophil to Lymphocyte Ratio as a Predictor of Poor Prognosis in Metastatic Pancreatic Cancer Patients Treated with Nab-Paclitaxel plus Gemcitabine: A Propensity Score Analysis. Gastroenterol Res Pract. 2018 Jun 10;2018:2373868. doi: 10.1155/2018/2373868. eCollection 2018.