Preoperative/neoadjuvant therapy may benefit patients with initially unresectable pancreatic cancer

Patients with initially unresectable pancreatic cancer might experience clinical benefits from neoadjuvant therapy, according to a study published in PLoS Medicine (2010 Apr 20;7(4):e1000267).

According to background information provided by the study's authors, pancreatic ductal adenocarcinoma is the fourth leading cause of cancer-related mortality and is associated with an extremely poor prognosis, with a median survival of 5.8 months. At present, the only chance for cure and prolonged survival is surgical resection.

To investigate whether neoadjuvant therapy for pancreatic cancer provides any clinical benefits, researchers analyzed data from 111 other studies involving 4,394 patients in which the effects of neoadjuvant chemotherapy and/or radiotherapy on tumor response, tumor respectability, and patient survival had been investigated.

Researchers found that the average survival time after preoperative/neoadjuvant therapy and surgery in patients whose tumor was initially judged unresectable before neoadjuvant therapy was similar to that of patients treated with chemotherapy and/or radiotherapy after surgery. After resection, the average survival time for these patients was 23.3 months, a similar survival time to that seen in patients treated with surgery and adjuvant therapy.

“The finding that a third of patients initially judged unresectable were able to undergo resection after neoadjuvant therapy and then had a similar survival rate to patients judged resectable before neoadjuvant treatment strongly suggests that patients presenting with locally advanced/unresectable tumors should be offered neoadjuvant therapy and then re-evaluated for resection,” the authors concluded.

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