Adjuvant treatment strategies for pancreatic cancer |
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Authors: | Erika A Newman MD Diane M Simeone MD Michael W Mulholland MD PhD |
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Institution: | (1) From the Section of Gastrointestinal Surgery, Department of Surgery, The University of Michigan Medical Center, Ann Arbor, Michigan |
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Abstract: | Pancreatic cancer is a difficult and unsolved surgical problem. It remains one of the top five causes of cancer-related deaths
and has the lowest 5-year survival of any cancer, largely due to late diagnosis, low resection rates, and local recurrence.
Clinical trials examining the optimal timing and delivery of adjuvant therapies for pancreatic cancer have yielded controversial
results. Although most experts agree that the addition of chemotherapy has survival benefit in patients with resectable pancreatic
cancer, there is no consensus regarding the optimal therapeutic agents, timing (neoadjuvant versus adjuvant), and the addition
of radiation therapy to the treatment regimen. Multiple phase III trials are in progress in efforts to examine these issues.
Additionally, exciting progress has been made with novel chemotherapeutic combinations, and alternative treatment modalities
including interferon-α, immunotherapy, and pancreatic cancer stem cells. Given the high failure pattern after surgical resection,
with more than half of patients developing locoregional recurrence, all patients undergoing pancreaticoduodenectomy are candidates
for adjuvant therapy. |
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Keywords: | Pancreas pancreatic cancer adjuvant therapy neoadjuvant therapy |
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