Neoadjuvant chemotherapy in pancreatic cancer: an appraisal of the current high-level evidence
At the time of diagnosis, only about 20% of patients with pancreatic ductal adenocarcinoma (PDAC) have resectable disease. PDAC treatment necessitates a multidisciplinary approach, and adjuvant chemotherapy after upfront resection is an established means of preventing recurrence. Neoadjuvant chemoth...
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| Main Authors: | , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2021
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| In: |
Pharmacology
Year: 2021, Volume: 106, Issue: 3/4, Pages: 143-153 |
| ISSN: | 1423-0313 |
| DOI: | 10.1159/000510343 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1159/000510343 Verlag, lizenzpflichtig, Volltext: https://www.karger.com/Article/FullText/510343 
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| Author Notes: | Philip C. Müller, Michael C. Frey, Claudio M. Ruzza, Felix Nickel, Christian Jost, Christoph Gwerder, Thilo Hackert, Kaspar Z’graggen, Ulf Kessler |
MARC
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| 520 | |a At the time of diagnosis, only about 20% of patients with pancreatic ductal adenocarcinoma (PDAC) have resectable disease. PDAC treatment necessitates a multidisciplinary approach, and adjuvant chemotherapy after upfront resection is an established means of preventing recurrence. Neoadjuvant chemotherapy (NAT), originally introduced to downstage tumor size, is nowadays more frequently used for selection of patients with favorable tumor biology and to control potential micrometastases. While NAT is routinely applied in locally advanced (LA) PDAC, there is increasing evidence demonstrating benefits of NAT in borderline resectable (BR) PDAC. The concept of NAT has recently been tested in resectable PDAC, but to date NAT has been restricted to clinical trials, as the data are limited and no clear benefits have yet been shown in this patient group. This review summarizes the current evidence for NAT in resectable, BR, and LA PDAC, with a focus on high-level evidence and randomized controlled trials. | ||
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