Locally advanced pancreatic cancer - New therapeutic challenges

Abstract

The overall survival rate of patients with pancreatic ductal adenocarcinoma remains extremely poor, and the only potentially curative treatment is radical surgery. There are three subgroups among the patients: primary resectable, metastatic and locally advanced pancreatic cancer. The term of locally ad advanced pancreatic cancer includes borderline resectable pancreatic cancer (BRPC) and unresectable pancreatic cancer (URPC). As in the case of BRPC, the strategy of induction treatment may convert the inoperable tumour into a resectable one. As in the case of URPC, the optimal standard of treatment is unknown. Recent advances in systemic treatment such as FOLFIRINOX (5-fluorouracil, leucovorin, irinotecan, oxaliplatin) and gemcitabine plus nab-paclitaxel as well as the optimisation of local treatment such as stereotactic radiotherapy (SBRT - stereotactic body radiation therapy) should be incorporated into future trials dedicated for BRPC and URPC.