nach oben

memo - Magazine of European Medical Oncology

Erschienen in:

10.08.2022 | short review

Neoadjuvant treatment of pancreatic ductal adenocarcinoma

verfasst von: Katharina Kosma, Sabine Thalhammer, Thomas Gruenberger

Erschienen in: memo - Magazine of European Medical Oncology | Ausgabe 3/2022

Einloggen, um Zugang zu erhalten

Summary

Neoadjuvant therapy in resectable and borderline resectable pancreatic cancer is the subject of several ongoing randomized controlled trials (RCTs). Retrospective studies and completed RCTs favor the use of neoadjuvant therapy in pancreatic cancer. Yet, the optimal chemotherapy regimen has not been defined. The objective of this report is to provide a review of currently available study data of neoadjuvant therapy in pancreatic cancer.

Vorheriger Artikel Neoadjuvant treatment in non-small-cell lung cancer—the earlier, the better

Nächster Artikel Neoadjuvant treatment in solid tumors—the earlier, the better in breast cancer

Dyba T, Randi G, Bray F, Martos C, Giusti F, Nicholson N, et al. The European cancer burden in 2020: incidence and mortality estimates for 40 countries and 25 major cancers. Eur J Cancer. 2021;157:308–47.CrossRef

Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2021. CA Cancer J Clin. 2021;71(1):7–33.CrossRef

Brunner M, Wu Z, Krautz C, Pilarsky C, Grützmann R, Weber GF. Current clinical strategies of pancreatic cancer treatment and open molecular questions. Int J Mol Sci. 2019;20(18):4543.CrossRef

Zaky AM, Wolfgang CL, Weiss MJ, Javed AA, Fishman EK, Zaheer A. Tumor-vessel relationships in pancreatic ductal adenocarcinoma at multidetector CT: different classification systems and their influence on treatment planning. Radiographics. 2017;37(1):93–112.CrossRef

Isaji S, Mizuno S, Windsor JA, Bassi C, Fernández-del Castillo C, Hackert T, et al. International consensus on definition and criteria of borderline resectable pancreatic ductal adenocarcinoma 2017. Pancreatology. 2018;18(1):2–11.CrossRef

Rhee H, Park MS. The role of imaging in current treatment strategies for pancreatic adenocarcinoma. Korean J Radiol. 2021;22(1):23.CrossRef

Marion-Audibert AM, Vullierme MP, Ronot M, Mabrut JY, Sauvanet A, Zins M, et al. Routine MRI with DWI sequences to detect liver metastases in patients with potentially resectable pancreatic ductal carcinoma and normal liver CT: a prospective multicenter study. Am J Roentgenol. 2018;211(5):W217–25.CrossRef

Tzeng CWD, Cao HST, Lee JE, Pisters PWT, Varadhachary GR, Wolff RA, et al. Treatment sequencing for resectable pancreatic cancer: influence of early metastases and surgical complications on multimodality therapy completion and survival. J Gastrointest Surg. 2014;18(1):16–25.CrossRef

Merkow RP, Bilimoria KY, Tomlinson JS, Paruch JL, Fleming JB, Talamonti MS, et al. Postoperative complications reduce adjuvant chemotherapy use in resectable pancreatic cancer. Ann Surg. 2014;260(2):372–7.CrossRef

10.

Bakens MJ, Geest LG, Putten M, Laarhoven HW, Creemers G, Besselink MG, et al. The use of adjuvant chemotherapy for pancreatic cancer varies widely between hospitals: a nationwide population-based analysis. Cancer Med. 2016;5(10):2825–31.CrossRef

11.

van Dam JL, Janssen QP, Besselink MG, Homs MYV, van Santvoort HC, van Tienhoven G, et al. Neoadjuvant therapy or upfront surgery for resectable and borderline resectable pancreatic cancer: a meta-analysis of randomised controlled trials. Eur J Cancer. 2022;160:140–9.CrossRef

12.

Versteijne E, Vogel JA, Besselink MG, Busch ORC, Wilmink JW, Daams JG, et al. Meta-analysis comparing upfront surgery with neoadjuvant treatment in patients with resectable or borderline resectable pancreatic cancer. Br J Surg. 2018;105(8):946–58.CrossRef

13.

Tempero MA, Malafa MP, Al-Hawary M, Asbun H, Bain A, Behrman SW, et al. Pancreatic adenocarcinoma, version 2.2017, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2017;15(8):1028–61.CrossRef

14.

Cloyd JM, Heh V, Pawlik TM, Ejaz A, Dillhoff M, Tsung A, et al. Neoadjuvant therapy for resectable and borderline resectable pancreatic cancer: a meta-analysis of randomized controlled trials. J Clin Med. 2020;9(4):1129.CrossRef

15.

Lee YS, Lee JC, Yang SY, Kim J, Hwang JH. Neoadjuvant therapy versus upfront surgery in resectable pancreatic cancer according to intention-to-treat and per-protocol analysis: a systematic review and meta-analysis. Sci Rep. 2019;9(1):15662.CrossRef

16.

Conroy T, Hammel P, Hebbar M, Ben Abdelghani M, Wei ACC, Raoul JL, et al. Unicancer GI PRODIGE 24/CCTG PA.6 trial: a multicenter international randomized phase III trial of adjuvant mFOLFIRINOX versus gemcitabine (gem) in patients with resected pancreatic ductal adenocarcinomas. J Clin Oncol. 2018;36(18_suppl):LBA4001.CrossRef

17.

Sugimoto M, Takahashi N, Farnell MB, Smyrk TC, Truty MJ, Nagorney DM, et al. Survival benefit of neoadjuvant therapy in patients with non-metastatic pancreatic ductal adenocarcinoma: a propensity matching and intention-to-treat analysis. J Surg Oncol. 2019;120(6):976–84.CrossRef

18.

Mokdad AA, Minter RM, Zhu H, Augustine MM, Porembka MR, Wang SC, et al. Neoadjuvant therapy followed by resection versus upfront resection for resectable pancreatic cancer: a propensity score matched analysis. J Clin Oncol. 2017;35(5):515–22.CrossRef

19.

Casadei R, Di Marco M, Ricci C, Santini D, Serra C, Calculli L, et al. Neoadjuvant chemoradiotherapy and surgery versus surgery alone in resectable pancreatic cancer: a single-center prospective, randomized, controlled trial which failed to achieve accrual targets. J Gastrointest Surg. 2015;19(10):1802–12.CrossRef

20.

Golcher H, Brunner TB, Witzigmann H, Marti L, Bechstein WO, Bruns C, et al. Neoadjuvant chemoradiation therapy with gemcitabine/cisplatin and surgery versus immediate surgery in resectable pancreatic cancer: results of the first prospective randomized phase II trial. Strahlenther Onkol. 2015;191(1):7–16.CrossRef

21.

Jang JY, Han Y, Lee H, Kim SW, Kwon W, Lee KH, et al. Oncological benefits of neoadjuvant chemoradiation with gemcitabine versus upfront surgery in patients with borderline resectable pancreatic cancer: a prospective, randomized, open-label, multicenter phase 2/3 trial. Ann Surg. 2018;268(2):215–22.CrossRef

22.

Ye M, Zhang Q, Chen Y, Fu Q, Li X, Bai X, et al. Neoadjuvant chemotherapy for primary resectable pancreatic cancer: a systematic review and meta-analysis. HPB. 2020;22(6):821–32.CrossRef

23.

Versteijne E, Suker M, Groothuis K, Akkermans-Vogelaar JM, Besselink MG, Bonsing BA, 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. 2020;38(16):1763–73.CrossRef

24.

Versteijne E, van Dam JL, Suker M, Janssen QP, Groothuis K, Akkermans-Vogelaar JM, 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. 2022;02233:21.

25.

Ahmad SA, Duong M, Sohal DPS, Gandhi NS, Beg MS, Wang-Gillam A, et al. Surgical outcome results from SWOG S1505: a randomized clinical trial of mFOLFIRINOX versus gemcitabine/nab-paclitaxel for perioperative treatment of resectable pancreatic ductal adenocarcinoma. Ann Surg. 2020;272(3):481–6.CrossRef

26.

Lambert A, Schwarz L, Ducreux M, Conroy T. Neoadjuvant treatment strategies in resectable pancreatic cancer. Cancers. 2021;13(18):4724.CrossRef

27.

Labori KJ, Lassen K, Hoem D, Grønbech JE, Søreide JA, Mortensen K, et al. Neoadjuvant chemotherapy versus surgery first for resectable pancreatic cancer (Norwegian Pancreatic Cancer Trial—1 (NorPACT-1))—study protocol for a national multicentre randomized controlled trial. BMC Surg. 2017;17(1):94.CrossRef

28.

Ettrich TJ, Berger AW, Perkhofer L, Daum S, König A, Dickhut A, et al. Neoadjuvant plus adjuvant or only adjuvant nab-paclitaxel plus gemcitabine for resectable pancreatic cancer—the NEONAX trial (AIO-PAK-0313), a prospective, randomized, controlled, phase II study of the AIO pancreatic cancer group. BMC Cancer. 2018;18(1):1298.CrossRef

29.

Schwarz L, Vernerey D, Bachet JB, Tuech JJ, Portales F, Michel P, et al. Resectable pancreatic adenocarcinoma neo-adjuvant FOLF(IRIN)OX-based chemotherapy—a multicenter, non-comparative, randomized, phase II trial (PANACHE01-PRODIGE48 study). BMC Cancer. 2018;18(1):762.CrossRef

30.

Janssen QP, van Dam JL, Bonsing BA, Bos H, Bosscha KP, et al. Total neoadjuvant FOLFIRINOX versus neoadjuvant gemcitabine-based chemoradiotherapy and adjuvant gemcitabine for resectable and borderline resectable pancreatic cancer (PREOPANC‑2 trial): study protocol for a nationwide multicenter randomized controlled trial. BMC Cancer. 2021;21(1):300. for the Dutch Pancreatic Cancer Group.CrossRef

31.

Hall WA, Dawson LA, Hong TS, Palta M, Herman JM, Evans DB, et al. Value of neoadjuvant radiation therapy in the management of pancreatic adenocarcinoma. J Clin Oncol. 2021;39(34):3773–7.CrossRef

32.

Hill CS, Rosati LM, Hu C, Fu W, Sehgal S, Hacker-Prietz A, et al. Neoadjuvant stereotactic body radiotherapy after upfront chemotherapy improves pathologic outcomes compared with chemotherapy alone for patients with borderline resectable or locally advanced pancreatic adenocarcinoma without increasing perioperative toxicity. Ann Surg Oncol. 2022;29(4):2456–68.CrossRef

33.

Arcelli A, Buwenge M, Macchia G, Bertini F, Guido A, Deodato F, et al. Stereotactic body radiotherapy vs conventionally fractionated chemoradiation in locally advanced pancreatic cancer: a multicenter case-control study (PAULA-1). Cancer Med. 2020;9(21):7879–87.CrossRef

Titel: Neoadjuvant treatment of pancreatic ductal adenocarcinoma
verfasst von: Katharina Kosma
Sabine Thalhammer
Thomas Gruenberger
Publikationsdatum: 10.08.2022
Verlag: Springer Vienna
Erschienen in: memo - Magazine of European Medical Oncology / Ausgabe 3/2022
Print ISSN: 1865-5041
Elektronische ISSN: 1865-5076
DOI: https://doi.org/10.1007/s12254-022-00832-7

Springer Medizin Österreich

Summary

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2022

Multiple myeloma with central nervous system relapse: a case report

Publisher Correction: Brain metastases: new systemic treatment approaches

Systemic inflammatory response index is a prognostic biomarker in unresectable pancreatic adenocarcinoma and identifies patients for more intensive treatment

Neoadjuvant treatment for solid tumors—the earlier, the better

Breast implant-associated anaplastic large-cell lymphoma: a European case report and literature review

Breast implant-associated anaplastic large-cell lymphoma—update on challenges, advances and opportunities