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Review
. 2022 Feb 14:11:744161.
doi: 10.3389/fonc.2021.744161. eCollection 2021.

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

Eva Versteijne  1 , Ignace H J T de Hingh  2 , Marjolein Y V Homs  3 , Martijn P W Intven  4 , Joost M Klaase  5 , Hjalmar C van Santvoort  6 , Judith de Vos-Geelen  7 , Johanna W Wilmink  8 , Geertjan van Tienhoven  1
Affiliations
Review

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

Eva Versteijne et al. Front Oncol. .

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: borderline resectable pancreatic cancer (BRPC); chemotherapy; neoadjuvant treatment; radiotherapy; resectable pancreatic cancer (RPC).

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Conflict of interest statement

JV-G has served as a consultant for Amgen, AstraZeneca, MSD, Pierre Fabre, and Servier, and has received institutional research funding from Servier (outside the submitted work). Johanna Wilmink: Research funding: Servier, Halozyme, Novartis, Celgene, Astra Zeneca, Pfizer, Roche, Merck, and Servier; Consulting/advisory role: Shire, Celgene, Servier, and Merck/MS (outside the submitted work). The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

    1. Park W, Chawla A, O’Reilly EM. Pancreatic Cancer: A Review. JAMA (2021) 326:851–62. doi: 10.1001/jama.2021.13027 - DOI - PMC - PubMed
    1. Rawla P, Sunkara T, Gaduputi V. Epidemiology of Pancreatic Cancer: Global Trends, Etiology and Risk Factors. World J Oncol (2019) 10:10–27. doi: 10.14740/wjon1166 - DOI - PMC - PubMed
    1. Matrisian LM, Berlin JD. The Past, Present, and Future of Pancreatic Cancer Clinical Trials. Am Soc Clin Oncol Educ Book (2016) 35:e205–15. doi: 10.1200/EDBK_159117 - DOI - PubMed
    1. Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2020. CA Cancer J Clin (2020) 70:7–30. doi: 10.3322/caac.21590 - DOI - PubMed
    1. Huang S, Chong H, Sun X, Wu Z, Jia Q, Zhang Y, et al. . The Value of (18)F-FDG PET/CT in Diagnosing Pancreatic Lesions: Comparison With CA19-9, Enhanced CT or Enhanced MR. Front Med (Lausanne) (2021) 8:668697. doi: 10.3389/fmed.2021.668697 - DOI - PMC - PubMed

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