Pancreatic Cancer in the Era of Neoadjuvant Therapy: A Narrative Overview.
Pancreatic adenocarcinoma is an aggressive systemic disease with around 30% of patient presenting locally advanced disease at diagnosis and being not candidate to surgical resection. Pioneering experiences with neoadjuvant treatment for locally advanced pancreatic cancer (LAPC) were undertaken more than 25 years ago and this strategy kept on gaining consensus over time. In recent years two main breakthroughs have been done: first, clear definitions of resectable, borderline resectable and locally advanced unresectable disease were released, and, soon after, two different chemotherapy regimens (namely, FOLFIRINOX and Gemcitabine plus Nab-Paclitaxel) were introduced in the clinical practice for LAPC after their effectiveness in metastatic patients was demonstrated. This article reviews papers regarding the administration of neoadjuvant chemotherapy, with or without radiation therapy, published from 2011 through 2017 with particular significance been given to reported results in term of resection rates, complete resection (R0) rates and Overall Survival, and briefly summarizes recommendations provided by the most recent guidelines for the treatment of non-metastatic pancreatic cancer.
['Casciani|Fabio|F|', 'Marchegiani|Giovanni|G|', 'Malleo|Giuseppe|G|', 'Bassi|Claudio|C|', 'Salvia|Roberto|R|']
D000230:Adenocarcinoma D000971:Antineoplastic Combined Chemotherapy Protocols D003841:Deoxycytidine D004338:Drug Combinations D005472:Fluorouracil D017408:Guidelines as Topic D006801:Humans D000077146:Irinotecan D002955:Leucovorin D020360:Neoadjuvant Therapy D009367:Neoplasm Staging D009942:Organometallic Compounds D000077150:Oxaliplatin D010190:Pancreatic Neoplasms D011379:Prognosis D016896:Treatment Outcome
FOLFIRINOX Gemcitabine locallyadvancedpancreaticcancer neoadjuvanttherapy pancreaticadenocarcinoma prognosis