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Role of neoadjuvant therapy for nonmetastatic pancreatic cancer: Current evidence and future perspectives
Authors:Gianluca Cassese  Ho-Seong Han  Yoo-Seok Yoon  Jun Suh Lee  Boram Lee  Antonio Cubisino  Fabrizio Panaro  Roberto Ivan Troisi
Abstract:Pancreatic adenocarcinoma (PDAC) is one of the most common and lethal human cancers worldwide. Surgery followed by adjuvant chemotherapy offers the best chance of a long-term survival for patients with PDAC, although only approximately 20% of the patients have resectable tumors when diagnosed. Neoadjuvant chemotherapy (NACT) is recommended for borderline resectable pancreatic cancer. Several studies have investigated the role of NACT in treating resectable tumors based on the recent advances in PDAC biology, as NACT provides the potential benefit of selecting patients with favorable tumor biology and controls potential micro-metastases in high-risk patients with resectable PDAC. In such challenging cases, new potential tools, such as ct-DNA and molecular targeted therapy, are emerging as novel therapeutic options that may improve old paradigms. This review aims to summarize the current evidence regarding the role of NACT in treating non-metastatic pancreatic cancer while focusing on future perspectives in light of recent evidence.
Keywords:Pancreatic cancer   Pancreatic duct adenocarcinoma   Neoadjuvant chemotherapy   Borderline resectable   Locally advanced pancreatic cancer
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