Neoadjuvant Treatment Strategies in Resectable Pancreatic Cancer
Medical Oncology Department, Institut de Cancérologie de Lorraine, CEDEX, 54519 Vandœuvre-lès-Nancy, France
Faculté de Médecine, Université de Lorraine, 54000 Nancy, France
Digestive Surgery Department, Rouen University Hospital, 1 rue de Germont, CEDEX, 76031 Rouen, France
Medical Oncology Department, Gustave Roussy, 39 rue Camille-Desmoulins, CEDEX, 94805 Villejuif, France
Université Paris Saclay, FCS Campus, 91190 Saint-Aubin, France
Author to whom correspondence should be addressed.
Academic Editor: Casper H.J. van Eijck
Received: 1 September 2021
Revised: 15 September 2021
Accepted: 15 September 2021
Published: 21 September 2021
Only 10–20% of patients with newly diagnosed resectable pancreatic adenocarcinoma have potentially resectable disease. Upfront surgery is the gold standard, but it is rarely curative. After surgical extirpation of tumors, up to 80% of patients will develop cancer recurrence, and the initial relapse is metastatic in 50–70% of these patients. Adjuvant chemotherapy offers the best strategy to date to improve overall survival but faces real challenges; some patients will experience rapid disease progression within 3 months of surgery and patients who do not receive all planned cycles of chemotherapy have unfavourable oncological outcomes. The neoadjuvant approach is therefore logical but requires further investigation. This approach shows favourable trends regarding disease-free survival and overall survival but, in the absence of rigorous published phase III trials, is not validated to date. Here, we intend to provide a comprehensive analysis of the literature to provide direction for future studies.