Advances in neoadjuvant therapy for resectable pancreatic cancer over the past two decades

Alvaro Gregorio Morales Taboada; Pablo Lozano Lominchar; Lorena Martin Roman; Pilar García-Alfonso; Andres Jesús Muñoz Martin; Jose Antonio Blanco Rodriguez; Jose Manuel Asencio Pascual

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자료유형: 학술저널

저자정보: Alvaro Gregorio Morales Taboada (Complutense University of Madrid) Pablo Lozano Lominchar (Complutense University of Madrid) Lorena Martin Roman (Complutense University of Madrid) Pilar García-Alfonso (Complutense University of Madrid) Andres Jesús Muñoz Martin (Complutense University of Madrid) Jose Antonio Blanco Rodriguez (Complutense University of Madrid) Jose Manuel Asencio Pascual (Complutense University of Madrid)

저널정보: 한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제25권 제2호

발행연도: 2021.5

수록면: 179 - 191 (13page)

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In the last two decades, pancreatic cancer has been undergoing important changes in its perioperative management due to the great interest in multidisciplinary management and preoperative multimodal therapy, which in numerous studies have shown promising clinical results. Although the standard of treatment for resectable pancreatic ductal adenocarcinoma (PDAC) today is surgery followed by adjuvant therapy, as it is a biologically aggressive disease, even with complete resection, it has high rates of local and distant relapse. Several retrospective and prospective phase I/II studies have opened the window for neoadjuvant therapy with chemotherapy (CT), chemoradiotherapy (CRT), or both, as an alternative treatment for resectable pancreatic cancer, with promising results. Neoadjuvant therapy could has some advantages, including early administration of systemic treatment, in vivo assessment of response to treatment, increase resectability rate in borderline patients, increase resection rate with negative margin and survival benefit. While it seems clear that even potentially resectable disease would benefit from preoperative multimodal therapy, the optimal neoadjuvant therapeutic strategy is still controversial and currently there are only recommendations for neoadjuvant treatment, in clinical guidelines such as the NCCN and ESMO, for borderline and/or locally advanced PDAC. This review provides an overview of recent studies available and how they relate to systemic treatment of resectable PDAC in the neoadjuvant setting.

#Resectable disease #Pancreatic ductal adenocarcinoma #Neoadjuvant therapy #Chemotherapy #Chemoradiotherapy

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