Neoadjuvant therapy for resectable pancreatic cancer

The use of neoadjuvant therapies has played a major role for borderline resectable and locally advanced pancreatic cancers(PCs). For this group of patients, preoperative chemotherapy or chemoradiation has increased the likelihood of surgery with negative resection margins and overall survival. On th...

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Published inWorld journal of gastrointestinal oncology Vol. 9; no. 12; pp. 457 - 465
Main Authors Rahman, Sheikh Hasibur, Urquhart, Robin, Molinari, Michele
Format Journal Article
LanguageEnglish
Published China Baishideng Publishing Group Inc 15.12.2017
Subjects
Minireviews
Neoadjuvant chemotherapy
Phase III trial
Borderline resectable
Phase II trial
Pancreatic adenocarcinoma
Phase I trial
Neoadjuvant chemoradiation therapy
Decision analysis
Randomized controlled trial
Locally advanced
Meta-analysis
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Summary:The use of neoadjuvant therapies has played a major role for borderline resectable and locally advanced pancreatic cancers(PCs). For this group of patients, preoperative chemotherapy or chemoradiation has increased the likelihood of surgery with negative resection margins and overall survival. On the other hand, for patients with resectable PC, the main rationale for neoadjuvant therapy is that the overall survival with current strategies is unsatisfactory. There is a consensus that we need new treatments to improve the overall survival and quality of life of patients with PC. However, without strong scientific evidence supporting the theoretical advantages of neoadjuvant therapies, these potential benefits might turn out not to be worth the risk of tumors progression while waiting for surgery. The focus of this paper is to provide the readers an overview of the most recent evidence on this subject.
Bibliography:Sheikh Hasibur Rahman;Robin Urquhart;Michele Molinari;Department of Surgery, Dalhousie University;Department of Surgery, University of Pittsburgh Medical Center
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Author contributions: Rahman SH participated in the concept, design and search of the scientific literature, extracted the data and wrote the manuscript including the tables; Urquhart R participated in the concept and design and participated in revising the manuscript; Molinari M formulated the research question, designed the literature search, supervised and co-authored the manuscript with Rahman SH.
Correspondence to: Michele Molinari, MD, MSc, Senior Scientist, Surgeon, Associate Professor, Department of Surgery, University of Pittsburgh Medical Center, 3459 Fifth Avenue, N758, Pittsburgh, PA 15213, United States. molinarim@upmc.edu
Telephone: +1-412-6475734 Fax: +1-412-6475736
ISSN:1948-5204
1948-5204
DOI:10.4251/wjgo.v9.i12.457