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 languageEnglish
Article number744161
Number of pages9
JournalFrontiers in Oncology
Volume11
DOIs
Publication statusPublished - 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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