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PANCREATIC CANCER

The role of neoadjuvant therapy for resectable pancreatic cancer remains uncertain

Nature Reviews Clinical Oncology volume 19, pages 285–286 (2022)Cite this article

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Patients with pancreatic ductal adenocarcinoma (PDAC) usually have a dismal prognosis, and even after curative resection most patients will have disease relapse and ultimately die. Nonetheless, adjuvant chemotherapy has considerably improved the outcomes of patients who are able to undergo surgery. The PREOPANC trial provides some evidence supporting the use of neoadjuvant therapy for patients with borderline resectable PDACs but not, as claimed, for those with resectable tumours.

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References

  1. Neoptolemos, J. P. et al. A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer. N. Engl. J. Med. 350, 1200–1210 (2004).

    Article  CAS  PubMed  Google Scholar 

  2. Neoptolemos, J. P. et al. Adjuvant chemotherapy with fluorouracil plus folinic acid vs gemcitabine following pancreatic cancer resection: a randomized controlled trial. J. Am. Med. Assoc. 304, 1073–1081 (2010).

    Article  CAS  Google Scholar 

  3. Conroy, T. et al. FOLFIRINOX or gemcitabine as adjuvant therapy for pancreatic cancer. N. Engl. J. Med. 379, 2395–2406 (2018).

    Article  CAS  PubMed  Google Scholar 

  4. Neoptolemos, J. P. et al. Comparison of adjuvant gemcitabine and capecitabine with gemcitabine monotherapy in patients with resected pancreatic cancer (ESPAC-4): a multicentre, open-label, randomised, phase 3 trial. Lancet 389, 1011–1024 (2017).

    Article  CAS  PubMed  Google Scholar 

  5. Versteijne, E. et al. Preoperative chemoradiotherapy versus immediate surgery for resectable and borderline resectable pancreatic cancer: results of the Dutch randomized phase III PREOPANC trial. J. Clin. Oncol. 38, 1763–1773 (2020).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Versteijne, E. et al. Neoadjuvant chemoradiotherapy versus upfront surgery for resectable and borderline resectable pancreatic cancer: long-term results of the Dutch randomized PREOPANC trial. J. Clin. Oncol. https://doi.org/10.1200/JCO.21.02233 (2022).

    Article  PubMed  Google Scholar 

  7. Katz, M. H. G. et al. Alliance A021501: preoperative mFOLFIRINOX or mFOLFIRINOX plus hypofractionated radiation therapy (RT) for borderline resectable (BR) adenocarcinoma of the pancreas. J. Clin. Oncol. 39, 377 (2021).

    Article  Google Scholar 

  8. Ghaneh, P. et al. ESPAC-5F: four-arm, prospective, multicenter, international randomized phase II trial of immediate surgery compared with neoadjuvant gemcitabine plus capecitabine (GEMCAP) or FOLFIRINOX or chemoradiotherapy (CRT) in patients with borderline resectable pancreatic cancer. J. Clin. Oncol. 38, 4505 (2020).

    Article  Google Scholar 

  9. Maeda, S. et al. Pathological treatment response has different prognostic implications for pancreatic cancer patients treated with neoadjuvant chemotherapy or chemoradiotherapy. Surgery https://doi.org/10.1016/j.surg.2021.10.015 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  10. Sohal, D. P. S. et al. Efficacy of perioperative chemotherapy for resectable pancreatic adenocarcinoma: a phase 2 randomized clinical trial. JAMA Oncol. 7, 421–427 (2021).

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We acknowledge statistical advice provided by R. Jackson (Head of Statistics, Cancer Division, Liverpool Clinical Trials Centre, The University of Liverpool).

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Authors and Affiliations

  1. Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany

    Christoph Springfeld

  2. Department of Surgery, Heidelberg University Hospital, Heidelberg, Germany

    John P. Neoptolemos

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  1. Christoph Springfeld
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  2. John P. Neoptolemos
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Correspondence to John P. Neoptolemos.

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Springfeld, C., Neoptolemos, J.P. The role of neoadjuvant therapy for resectable pancreatic cancer remains uncertain. Nat Rev Clin Oncol 19, 285–286 (2022). https://doi.org/10.1038/s41571-022-00612-6

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