[Hope and frustration of neoadjuvant chemotherapy for resectable pancreatic cancer]

There are many shortcomings in the existing strategy for the treatment of resectable pancreatic cancer by surgery combined with postoperative adjuvant chemotherapy.Neoadjuvant chemotherapy has the effects of clearing micrometastases, improving the margins, and assessing chemosensitivity of resectable pancreatic cancer.Currently, neoadjuvant chemotherapy is still mainly used for borderline resectable pancreatic cancer and unresectable pancreatic cancer.However, resectability assessment, patients selection, choice of chemotherapy regimens, assessment of chemotherapy response, chemotherapy cycles, and timing for surgery are still undetermined.At the same time, the mainstream regimens are highly toxic, expensive, and have a long course of treatment.It is still a small number of patients that can successfully pass the chemotherapy screening to undergo resection.It should be recognized that pancreatic cancer is still a chemotherapy-insensitive tumor.There are many unreasonable ways to use neoadjuvant chemotherapy in pancreatic cancer like chemotherapy-sensitive tumors.We need to explore more scientific, economical and applicable approaches for neoadjuvant chemotherapy on resectable pancreatic cancer.