Advances and challenges of neoadjuvant therapy in pancreatic cancer. Issue 6 (8th November 2020)

• Record Type: Journal Article
• Authors: Yu, Yang; Zheng, Peng; Chen, Yajing; Wang, Bofang; Paul, Maswikiti Ewetse; Tao, Pengxian; Wang, Dengfeng; Li, Haiyuan; Gu, Baohong; Gao, Lei; Wang, Dan; Chen, Hao
• Is Part Of: Asia-Pacific journal of clinical oncology. Volume 17:Issue 6(2021)
• Page Start: 425
• Page End: 434
• Publication Date: 2020-11-08
• Subjects: FOLFIRINOX -- neoadjuvant therapy -- pancreatic cancer -- resectability -- review; Oncology -- Pacific Area -- Periodicals; Cancer -- Treatment -- Pacific Area -- Periodicals; Cancer -- Pacific Area -- Periodicals; Cancer -- Treatment -- Periodicals; 616.9940095
• DOI: 10.1111/ajco.13504
• Languages: English
• ISSNs: 1743-7555

Abstract

Abstract: Pancreatic cancer has been becoming the second cause of cancer death in the western world, and its disease burden has increased. Neoadjuvant therapy is one of the current research hotspots in the field of pancreatic cancer, aiming to improve the surgical rate and prognosis of pancreatic cancer. Based on the latest evidence, this review discussed neoadjuvant therapy in pancreatic cancer from the following three aspects: patient selection, protocols selection of neoadjuvant therapy, and treatment response evaluation and resectability prediction. A big controversy existed on the indications of neoadjuvant treatment, but it was agreed that any patient who is likely to achieve R0 resection due to neoadjuvant therapy should be the targeted population. A variety of chemotherapy regimens were tried for neoadjuvant therapy in pancreatic cancer, and FOLFIRINOX and Nab‐Paclitaxel plus Gemcitabine are two preferred regimens at present. It was challenging to evaluate treatment response and predict resectability after neoadjuvant therapy, although imaging by CT is widely used. Based on new findings of the remarkable performance of several chemotherapy regimens with or without radiotherapy, the neoadjuvant indications of pancreatic cancer have extended in recent years. However, it is still a challenge to assess the neoadjuvant treatment response and determine the timing of surgery. Abstract : Neoadjuvant therapy has been widely tried in pancreatic cancer, and showed an impressive potential in improving resection rate and overall survival. However, a variety of challenges still exist due to the special biological characteristics of pancreatic cancer.