Cancers, Vol. 13, Pages 4724: Neoadjuvant Treatment Strategies in Resectable Pancreatic Cancer

Cancers, Vol. 13, Pages 4724: Neoadjuvant Treatment Strategies in Resectable Pancreatic Cancer Cancers doi: 10.3390/cancers13184724 Authors: Aurélien Lambert Lilian Schwarz Michel Ducreux Thierry Conroy Complete surgical resection is the cornerstone of curative therapy for resectable pancreatic adenocarcinoma. Upfront surgery is the gold standard, but it is rarely curative. Neoadjuvant treatment is a logical option, as it may overcome some of the limitations of adjuvant therapy and has already shown some encouraging results. The main concern regarding neoadjuvant therapy is the risk of disease progression during chemotherapy, meaning the opportunity to undergo the intended curative surgery is missed. We reviewed all recent literature in the following areas: major surveys, retrospective studies, meta-analyses, and randomized trials. We then selected the ongoing trials that we believe are of interest in this field and report here the results of a comprehensive review of the literature. Meta-analyses and randomized trials suggest that neoadjuvant treatment has a positive effect. However, no study to date can be considered practice changing. We considered design, endpoints, inclusion criteria and results of available randomized trials. Neoadjuvant treatment appears to be at least a feasible strategy for patients with resectable pancreatic cancer.
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Review Source Type: research

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AbstractMultimodal treatment including surgery and chemotherapy is considered the gold standard treatment of pancreatic cancer by most guidelines. Neoadjuvant therapy (NAT) has been seen as a possible treatment option for resectable, borderline resectable and locally advanced PaC. The aim of this paper is to offer a state-of-the-art review on neoadjuvant treatments in the setting of pancreatic ductal adenocarcinoma. A systematic literature search was performed using PubMed, Cochrane, Web of Science and Embase databases, in order to identify relevant studies published up to and including July 2021 that reported and analyzed...
Source: Updates in Surgery - Category: Surgery Source Type: research
CONCLUSIONS: Our study reveals that neoadjuvant chemotherapy with FOLFIRINOX enhances effector T cells and downregulates suppressor cells. These data indicate that FOLFIRINOX neoadjuvant therapy may improve immune therapy and clinical outcome in PDAC patients.PMID:34593529 | DOI:10.1158/1078-0432.CCR-21-0998
Source: Clinical Cancer Research - Category: Cancer & Oncology Authors: Source Type: research
Formisano Roberto Bianco Patients with locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC) do not present distant metastases but are not eligible for surgery upfront. Chemotherapy regimens, such as FOLFIRINOX (FFN) or nab-paclitaxel plus gemcitabine (GemNab) in combination with loco-regional treatments are generally used in this setting. However, the best treatment choice is unknown. We retrospectively analyzed the information of 225 patients with stage II–III PDAC treated at our institution between October 2011 and December 2020. A total of 94 patients with LA PDAC who are non-eligible for surgery u...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Article Source Type: research
CONCLUSION: Resistance development in neoadjuvant FOLFIRINOX organoids, recapitulating their primary tumor resistance, suggests continuation of FOLFIRINOX therapy as an adjuvant treatment may not be advantageous for these patients. Gene expression profiles of PDAC organoids identify targetable pathways involved in chemoresistance development upon neoadjuvant FOLFIRINOX treatment, thus opening up combination therapy possibilities.PMID:34580113 | DOI:10.1158/1078-0432.CCR-21-1681
Source: Clinical Cancer Research - Category: Cancer & Oncology Authors: Source Type: research
ConclusionCompared to historical data, neoadjuvant autophagy inhibition with HCQ plus gemcitabine is associated with encouraging long-term survival for patients with PDAC.
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: RESEARCH ARTICLE Source Type: research
Michele Ghidini Pancreatic ductal adenocarcinoma (PDAC) has an aggressive tumor biology and is associated with poor survival outcomes. Most patients present with metastatic or locally advanced disease. In the 10–20% of patients with upfront resectable disease, surgery offers the only chance of cure, with the addition of adjuvant chemotherapy representing an established standard of care for improving outcomes. Despite resection followed by adjuvant chemotherapy, at best, 3-year survival reaches 63.4%. Post-operative complications and poor performance mean that around 50% of the patients do not commence adjuvant ...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Review Source Type: research
This study is the first randomized phase II study comparing GS combination therapy with GA combination therapy as NAC for localized pancreatic cancer.Trial registrationUMIN Clinical Trials RegistryUMIN000021484. This trial began in April 2016.
Source: Trials - Category: Research Source Type: clinical trials
Am Surg. 2021 Aug 12:31348211038581. doi: 10.1177/00031348211038581. Online ahead of print.ABSTRACTBACKGROUND: Neoadjuvant chemotherapy (CT) is being utilized more frequently in patients diagnosed with localized pancreatic cancer. The role of additional neoadjuvant radiotherapy (RT) remains undefined. We explored outcomes associated with neoadjuvant RT in the modern era.METHODS: The National Cancer Database (2010-2017) was queried for patients with clinical stage II-III pancreatic adenocarcinoma who received neoadjuvant multiagent systemic CT +/- RT. Demographics, pathologic outcomes, postoperative outcomes, and overall su...
Source: The American Surgeon - Category: Surgery Authors: Source Type: research
World J Gastroenterol. 2021 Jul 21;27(27):4383-4394. doi: 10.3748/wjg.v27.i27.4383.ABSTRACTPancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy that is best treated in a multidisciplinary fashion using surgery, chemotherapy, and radiation. Adjuvant chemotherapy has shown to have a significant survival benefit in patients with resected PDAC. However, up to 50% of patients fail to receive adjuvant chemotherapy due to postoperative complications, poor patient performance status or early disease progression. In order to ensure the delivery of chemotherapy, an alternative strategy is to administer systemic treatm...
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Source Type: research
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