Neoadjuvant Treatment for Resectable and Borderline Resectable Pancreatic Cancer: Chemotherapy or Chemoradiotherapy?

E. Versteijne; I.H.J.T. de Hingh; M.Y.V. Homs; M.P.W. Intven; J.M. Klaase; H.C. van Santvoort; J. de Vos-Geelen; J.W. Wilmink; G. van Tienhoven

doi:10.3389/fonc.2021.744161

Neoadjuvant Treatment for Resectable and Borderline Resectable Pancreatic Cancer: Chemotherapy or Chemoradiotherapy?

E. Versteijne^*, I.H.J.T. de Hingh, M.Y.V. Homs, M.P.W. Intven, J.M. Klaase, H.C. van Santvoort, J. de Vos-Geelen, J.W. Wilmink, G. van Tienhoven

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

Abstract

Worldwide, there is a shifting paradigm from immediate surgery with adjuvant treatment to a neoadjuvant approach for patients with resectable or borderline resectable pancreatic cancer (RPC or BRPC). Comparison of neoadjuvant and adjuvant studies is extremely difficult because of a great difference in patient selection. The evidence from randomized studies shows that overall survival by intention-to-treat improves after neoadjuvant gemcitabine-based chemoradiotherapy or chemotherapy (various regimens), as compared to immediate surgery followed by adjuvant chemotherapy. Radiotherapy appears to play an important role in mediating locoregional effects. Yet, since more effective chemotherapy regimens are currently available, in particular FOLFIRINOX and Gemcitabine/Nab-paclitaxel, these chemotherapy regimens should be investigated in future randomized trials combined with (stereotactic) radiotherapy to further improve outcomes of RPC and BRPC.

Original language	English
Article number	744161
Number of pages	9
Journal	Frontiers in Oncology
Volume	11
DOIs	https://doi.org/10.3389/fonc.2021.744161
Publication status	Published - 14 Feb 2022

Keywords

resectable pancreatic cancer (RPC)
borderline resectable pancreatic cancer (BRPC)
chemotherapy
radiotherapy
neoadjuvant treatment
FULL-DOSE GEMCITABINE
ADJUVANT CHEMOTHERAPY
DUCTAL ADENOCARCINOMA
CONCURRENT RADIATION
UPFRONT SURGERY
OPEN-LABEL
THERAPY
MULTICENTER
CHEMORADIATION
RESECTION

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10.3389/fonc.2021.744161Licence: CC BY

Cite this

Versteijne, E., de Hingh, I. H. J. T., Homs, M. Y. V., Intven, M. P. W., Klaase, J. M., van Santvoort, H. C., de Vos-Geelen, J., Wilmink, J. W., & van Tienhoven, G. (2022). Neoadjuvant Treatment for Resectable and Borderline Resectable Pancreatic Cancer: Chemotherapy or Chemoradiotherapy? Frontiers in Oncology, 11, Article 744161. https://doi.org/10.3389/fonc.2021.744161

@article{4eec92f0e8394041b1ce3a90411607de,

title = "Neoadjuvant Treatment for Resectable and Borderline Resectable Pancreatic Cancer: Chemotherapy or Chemoradiotherapy?",

abstract = "Worldwide, there is a shifting paradigm from immediate surgery with adjuvant treatment to a neoadjuvant approach for patients with resectable or borderline resectable pancreatic cancer (RPC or BRPC). Comparison of neoadjuvant and adjuvant studies is extremely difficult because of a great difference in patient selection. The evidence from randomized studies shows that overall survival by intention-to-treat improves after neoadjuvant gemcitabine-based chemoradiotherapy or chemotherapy (various regimens), as compared to immediate surgery followed by adjuvant chemotherapy. Radiotherapy appears to play an important role in mediating locoregional effects. Yet, since more effective chemotherapy regimens are currently available, in particular FOLFIRINOX and Gemcitabine/Nab-paclitaxel, these chemotherapy regimens should be investigated in future randomized trials combined with (stereotactic) radiotherapy to further improve outcomes of RPC and BRPC.",

keywords = "resectable pancreatic cancer (RPC), borderline resectable pancreatic cancer (BRPC), chemotherapy, radiotherapy, neoadjuvant treatment, FULL-DOSE GEMCITABINE, ADJUVANT CHEMOTHERAPY, DUCTAL ADENOCARCINOMA, CONCURRENT RADIATION, UPFRONT SURGERY, OPEN-LABEL, THERAPY, MULTICENTER, CHEMORADIATION, RESECTION",

author = "E. Versteijne and {de Hingh}, I.H.J.T. and M.Y.V. Homs and M.P.W. Intven and J.M. Klaase and {van Santvoort}, H.C. and {de Vos-Geelen}, J. and J.W. Wilmink and {van Tienhoven}, G.",

note = "Publisher Copyright: Copyright {\textcopyright} 2022 Versteijne, de Hingh, Homs, Intven, Klaase, van Santvoort, de Vos-Geelen, Wilmink and van Tienhoven.",

year = "2022",

month = feb,

day = "14",

doi = "10.3389/fonc.2021.744161",

language = "English",

volume = "11",

journal = "Frontiers in Oncology",