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Published on: January 3, 2020
Updates and Review of Neoadjuvant Therapy for Resectable Pancreatic Cancer
William Cobb1, Daniel Rozefort2, Chunghun Ji2
1Department of General Surgery, AdventHealth Orlando, Orlando, Florida, USA, william.cobb.md@adventhealth.com.
Background:
Pancreatic adenocarcinoma (PDAC) is a disease process that carries high morbidity and mortality and is suspected to supplant colorectal cancer as the second leading cause of cancer-related death in the USA. Resectable disease is considered no tumor contact with the celiac axis, common hepatic artery, or superior mesenteric artery and less than 180-degrees contact with portal vein or superior mesenteric vein. The current standard of care for resectable disease is surgery.
Summary:
There is an ongoing paradigm shift to consider neoadjuvant therapy (NAT) for initially resectable disease and this review aims to summarize the updates in NAT for resectable pancreatic cancer. We performed a literature search of NAT for resectable PDAC and reviewed pertinent literature for current treatment regimens, clinical trials comparing NAT to up-front resection, and other modalities in the treatment of PDAC.
Key Messages:
Retrospective studies, recent completed prospective studies, and ongoing trials are showing an increased consideration for NAT for resectable PDAC compared with up-front surgery. Additionally, immunotherapy, cell therapy, and matrix-depleting therapy are promising new avenues in the treatment of pancreatic cancers.
