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Review
. 2020 Feb 18;4(2):100-108.
doi: 10.1002/ags3.12311. eCollection 2020 Mar.

Neoadjuvant treatment for resectable pancreatic adenocarcinoma: What is the best protocol?

Fuyuhiko Motoi  1 , Michiaki Unno  1
Affiliations
Review

Neoadjuvant treatment for resectable pancreatic adenocarcinoma: What is the best protocol?

Fuyuhiko Motoi et al. Ann Gastroenterol Surg. .

Abstract

Although upfront surgery has been the gold standard for pancreatic adenocarcinoma that is planned for resection, it should be compared with the alternative strategy of neoadjuvant therapy. Despite the many reports of the efficacy of neoadjuvant therapy, most of them were not comparative. Recently Prep-02/JSAP05 study clearly demonstrated the significant survival benefit of neoadjuvant chemotherapy over upfront surgery for pancreatic adenocarcinoma that is planned for resection. These findings opened a new chapter of neoadjuvant therapy. Ongoing trials are expected to confirm the evidence. This review summarizes the past, present, and future perspectives of neoadjuvant therapy and its optimization.

Keywords: neoadjuvant chemotherapy; neoadjuvant therapy; pancreatic adenocarcinoma; resectable pancreatic cancer.

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Figures

Figure 1
Figure 1
Patient selection for up‐front surgical strategy. The gray box represents ineligible cases for postoperative adjuvant treatment. †Incomplete resection includes unresectable at the time of surgery, macroscopic positive margin resection (R2 resection), resection with metastatic disease (M1)
Figure 2
Figure 2
Patient selection for neoadjuvant strategy. The gray box represents ineligible cases for postoperative adjuvant treatment. †Incomplete resection includes unresectable at the time of surgery, macroscopic positive margin resection (R2 resection), resection with metastatic disease (M1)
See this image and copyright information in PMC

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