Trends in neoadjuvant approaches in pancreatic cancer

Lingling Du, Andrea Wang-Gillam

Research output: Contribution to journalReview articlepeer-review

21 Scopus citations

Abstract

Pancreatic cancer (PDAC) is an aggressive tumor type associated with development of micrometastasis at an early stage. In attempt to eradicate disseminated disease, neoadjuvant therapy has been explored in patients with resectable and borderline resectable PDAC. In large retrospective studies, neoadjuvant therapy was associated with better survival compared with upfront surgery. Previously, trials more commonly used radiotherapy (RT) with small doses of chemotherapy as radiosensitizers. Recent studies, however, have incorporated full systemic doses of chemotherapy with or without RT before surgery with the hope of achieving adequate systemic chemotherapy coverage and improving survival. Several phase II trials have shown encouraging clinical benefits using the neoadjuvant approach. Large cooperative group studies are exploring the role of neoadjuvant treatment with newer combination chemotherapy regimens and modern RT techniques, which will provide more evidence regarding the utility of this approach.

Original languageEnglish
Pages (from-to)1070-1077
Number of pages8
JournalJNCCN Journal of the National Comprehensive Cancer Network
Volume15
Issue number8
DOIs
StatePublished - Aug 2017

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