Year 2022 / Volume 114 / Number 7
Editorial
Neoadjuvant treatment in localized and resectable cancer of the pancreas: a new therapeutic paradigm

371-374

DOI: 10.17235/reed.2022.8925/2022

Pablo Martí-Cruchaga, Javier A. Cienfuegos, Fernando Rotellar,

Abstract
Ductal carcinoma of the pancreas (DCP) is one of the most devastating tumors and ranks fourth among the causes of death from cancer. It is estimated that by 2030 it will be among the top three “cancer killers”, along with lung cancer and hepatocarcinoma. Overall survival at five years from diagnosis is 5-10% in centers with experience. At the time of diagnosis, only 10-15% of patients present tumors localized to the pancreas and which are susceptible to curative resection (R0) (resectable tumors). Fifty percent present with systemic disease (stage IV) and 30-35% present borderline or locally advanced tumors which are generally not resectable due to vascular invasion.
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References
1. Mizrahi JD, Surana R, Valle JW, Shroff RT. Pancreatic cancer. The Lancet 2020;395:2008–2020.
2. Park W, Chawla A, O’Reilly EM. Pancreatic Cancer: A Review. JAMA 2021;326:851–862..
3. Rahib L, Smith BD, Aizenberg R, Rosenzweig AB, Fleshman JM, Matrisian LM. Projecting cancer incidence and deaths to 2030: The unexpected burden of thyroid, liver, and pancreas cancers in the united states. Cancer Res 2014;74:2913–2921.
4. Kneuertz PJ, Pitt HA, Bilimoria KY, et al. Risk of morbidity and mortality following hepato-pancreato-biliary surgery. J Gastrointest Surg  2012;16:1727-35
5. Patel SH, Katz MHG, Ahmad SA. The Landmark Series: Preoperative Therapy for Pancreatic Cancer. Ann Sur Oncol 2021;28:4104–4129.
6. Ward EP, Evans DB, Tsai S. Ten-year experience in optimizing neoadjuvant therapy for localized pancreatic cancer—Medical college of Wisconsin perspective. J Surg Oncol 2021;123:1405–1413.
7. Mavros MN, Moris Di, Karanicolas PJ, et al. Clinical Trials of Systemic Chemotherapy for Resectable Pancreatic Cancer: A Review. JAMA Surg 2021;156:663–672.
8. Isaji S, Mizuno S, Windsor JA, et al. International consensus on definition and criteria of borderline resectable pancreatic ductal adenocarcinoma 2017. Pancreatology 2018;18:2–11.
9. Tempero MA, Malafa MP, Al-Hawary M, et al. Pancreatic adenocarcinoma, version 2.2017: Clinical practice guidelines in Oncology. JNCCN Journal of the National Comprehensive Cancer Network 2017;15:1028–1061.
10. Park W, Chawla A, O’Reilly EM. Pancreatic Cancer: A Review. JAMA 2021;326:851–862.
11. Neoptolemos JP, Palmer DH, Ghaneh P, et al. Comparison of adjuvant gemcitabine and capecitabine with gemcitabine monotherapy in patients with resected pancreatic cancer (ESPAC-4): a multicentre, open-label, randomised, phase 3 trial. Lancet 2017;389:1011–1024.
12. Conroy T, Hammel P, Hebbar M, et al. FOLFIRINOX or Gemcitabine as Adjuvant Therapy for Pancreatic Cancer. N Engl J Med 2018;379:2395–2406.
13. Merkow RP, Bilimoria KY, Tomlinson JS, et al. Postoperative complications reduce adjuvant chemotherapy use in resectable pancreatic cancer. Ann Surg 2014;260:372–377.
14. Khachfe HH, Habib JR, Nassour I, et al. Borderline resectable and locally advanced pancreatic cancers: A review of definitions, diagnostics, strategies for treatment, and future directions. Pancreas 2021;50:1243–1249.
15. Evans DB, Rich TA, Byrd DR, et al. Preoperative Chemoradiation and Pancreaticoduodenectomy for Adenocarcinoma of the Pancreas. Arch Surg 1992;127:1335–1339.
16. Cloyd JM, Katz MHG, Prakash L, et al. Preoperative Therapy and Pancreatoduodenectomy for Pancreatic Ductal Adenocarcinoma: a 25-Year Single-Institution Experience. J Gastrointest Surg 2017;21:164–174.
17. Wittmann D, Hall WA, Christians KK, et al. Impact of Neoadjuvant Chemoradiation on Pathologic Response in Patients With Localized Pancreatic Cancer. Front oncol 2020;10:460..
18. Sohal DPS, Duong M, Ahmad SA, et al. Efficacy of Perioperative Chemotherapy for Resectable Pancreatic Adenocarcinoma: A Phase 2 Randomized Clinical Trial. JAMA Oncology 2021;7:421–427.
19. Soloff E, Al-Hawary M, Desser TS, et al. Imaging Assessment of Pancreatic Cancer Resectability after Neoadjuvant Therapy: AJR Expert Panel Narrative Review. AJR Am J Roentgenol 2021;218 570-581..
20. Quiros RM, Brown KM, Hoffman JP. Neoadjuvant therapy in pancreatic cancer. Cancer Invest 2007;25:267–273.
21. Gemenetzis G, Groot VP, Yu J, et al. Circulating Tumor Cells Dynamics in Pancreatic Adenocarcinoma Correlate With Disease Status: Results of the Prospective CLUSTER Study. Ann Surg 2018;268:408–420.
22. Jang JY, Han Y, Lee H, et al. Oncological Benefits of Neoadjuvant Chemoradiation With Gemcitabine Versus Upfront Surgery in Patients With Borderline Resectable Pancreatic Cancer: A Prospective, Randomized, Open-label, Multicenter Phase 2/3 Trial. Ann Surg 2018;268:215–222.
23. Versteijne E, van Dam JL, Suker M, et al. Neoadjuvant Chemoradiotherapy Versus Upfront Surgery for Resectable and Borderline Resectable Pancreatic Cancer: Long-Term Results of the Dutch Randomized PREOPANC Trial. J Clin Oncol 2022;40:1220–1230.
24. Garcia-Aguilar J, Patil S, Gollub MJ, et al. Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy. J Clin Oncol 2022:JCO2200032. Available at: http://www.ncbi.nlm.nih.gov/pubmed/35483010.Online ahead of print
25. Birrer DL, Golcher H, Casadei R, et al. Neoadjuvant Therapy for Resectable Pancreatic Cancer: A New Standard of Care. Pooled Data From 3 Randomized Controlled Trials. Ann Surg 2021;274:713–720.
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Martí-Cruchaga P, Cienfuegos J, Rotellar F. Neoadjuvant treatment in localized and resectable cancer of the pancreas: a new therapeutic paradigm. 8925/2022


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Publication history

Received: 12/05/2022

Accepted: 13/05/2022

Online First: 31/05/2022

Published: 07/07/2022

Article Online First time: 19 days

Article editing time: 56 days


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