Should every patient with pancreatic cancer receive perioperative/neoadjuvant therapy?

Pancreatic ductal adenocarcinoma is a highly aggressive disease, and medical as well as surgical therapeutic options are limited. This article reviews stage dependent treatment options, with a special focus on the current controversy of perioperative treatment regimens in initially borderline resect...

Full description

Saved in:
Bibliographic Details
Main Authors: Ulrich Nitsche, Bo Kong, Alexander Balmert, Helmut Friess, Jörg Kleeff
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2016-01-01
Series:Indian Journal of Medical and Paediatric Oncology
Subjects:
Online Access:http://www.ijmpo.org/article.asp?issn=0971-5851;year=2016;volume=37;issue=4;spage=211;epage=213;aulast=Nitsche
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850177391337406464
author Ulrich Nitsche
Bo Kong
Alexander Balmert
Helmut Friess
Jörg Kleeff
author_facet Ulrich Nitsche
Bo Kong
Alexander Balmert
Helmut Friess
Jörg Kleeff
author_sort Ulrich Nitsche
collection DOAJ
description Pancreatic ductal adenocarcinoma is a highly aggressive disease, and medical as well as surgical therapeutic options are limited. This article reviews stage dependent treatment options, with a special focus on the current controversy of perioperative treatment regimens in initially borderline resectable or locally advanced patients. Neoadjuvant treatment can potentially increase the rate of complete tumor resection and may be more effective than adjuvant systemic therapy. Further, in the case of disease progression during or after neoadjuvant therapy, patients can be spared extensive surgery. Today, common therapeutic regimens include gemcitabine/nab-paclitaxel and FOLFIRINOX, as well as chemoradiation. However, because of the paucity of evidence from randomized trials, most guidelines do not recommend neoadjuvant therapy in resectable tumors, and for borderline or locally advanced tumors only within clinical trials. Importantly, every patient should be discussed in multidisciplinary tumor boards.
format Article
id doaj-art-bee280fb122b49549a7ad1ae6c880aee
institution OA Journals
issn 0971-5851
language English
publishDate 2016-01-01
publisher Thieme Medical and Scientific Publishers Pvt. Ltd.
record_format Article
series Indian Journal of Medical and Paediatric Oncology
spelling doaj-art-bee280fb122b49549a7ad1ae6c880aee2025-08-20T02:18:58ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Medical and Paediatric Oncology0971-58512016-01-0137421121310.4103/0971-5851.195731Should every patient with pancreatic cancer receive perioperative/neoadjuvant therapy?Ulrich NitscheBo KongAlexander BalmertHelmut FriessJörg KleeffPancreatic ductal adenocarcinoma is a highly aggressive disease, and medical as well as surgical therapeutic options are limited. This article reviews stage dependent treatment options, with a special focus on the current controversy of perioperative treatment regimens in initially borderline resectable or locally advanced patients. Neoadjuvant treatment can potentially increase the rate of complete tumor resection and may be more effective than adjuvant systemic therapy. Further, in the case of disease progression during or after neoadjuvant therapy, patients can be spared extensive surgery. Today, common therapeutic regimens include gemcitabine/nab-paclitaxel and FOLFIRINOX, as well as chemoradiation. However, because of the paucity of evidence from randomized trials, most guidelines do not recommend neoadjuvant therapy in resectable tumors, and for borderline or locally advanced tumors only within clinical trials. Importantly, every patient should be discussed in multidisciplinary tumor boards.http://www.ijmpo.org/article.asp?issn=0971-5851;year=2016;volume=37;issue=4;spage=211;epage=213;aulast=NitscheNeoadjuvantpancreatic cancerpancreatic ductal adenocarcinomaperioperative
spellingShingle Ulrich Nitsche
Bo Kong
Alexander Balmert
Helmut Friess
Jörg Kleeff
Should every patient with pancreatic cancer receive perioperative/neoadjuvant therapy?
Indian Journal of Medical and Paediatric Oncology
Neoadjuvant
pancreatic cancer
pancreatic ductal adenocarcinoma
perioperative
title Should every patient with pancreatic cancer receive perioperative/neoadjuvant therapy?
title_full Should every patient with pancreatic cancer receive perioperative/neoadjuvant therapy?
title_fullStr Should every patient with pancreatic cancer receive perioperative/neoadjuvant therapy?
title_full_unstemmed Should every patient with pancreatic cancer receive perioperative/neoadjuvant therapy?
title_short Should every patient with pancreatic cancer receive perioperative/neoadjuvant therapy?
title_sort should every patient with pancreatic cancer receive perioperative neoadjuvant therapy
topic Neoadjuvant
pancreatic cancer
pancreatic ductal adenocarcinoma
perioperative
url http://www.ijmpo.org/article.asp?issn=0971-5851;year=2016;volume=37;issue=4;spage=211;epage=213;aulast=Nitsche
work_keys_str_mv AT ulrichnitsche shouldeverypatientwithpancreaticcancerreceiveperioperativeneoadjuvanttherapy
AT bokong shouldeverypatientwithpancreaticcancerreceiveperioperativeneoadjuvanttherapy
AT alexanderbalmert shouldeverypatientwithpancreaticcancerreceiveperioperativeneoadjuvanttherapy
AT helmutfriess shouldeverypatientwithpancreaticcancerreceiveperioperativeneoadjuvanttherapy
AT jorgkleeff shouldeverypatientwithpancreaticcancerreceiveperioperativeneoadjuvanttherapy