Neoadjuvant therapy for pancreatic cancer: A review of the evidence

Abstract

Pancreatic cancer remains one of the representative solid cancers which have dismal outcome. Neoadjuvant therapy has received attention as one of the possible breakthrough methods because the limit of extensive surgery has been reported and effective chemotherapy has been introduced clinically for pancreatic cancer. To establish the standard neoadjuvant therapy, the safety, acceptability and effectiveness need to be proven through clinical trials. The resectability classification of pancreatic cancer has been proposed in the General Rules of Pancreatic Cancer 7th edition issued by the Japan Pancreatic Society. The treatment strategies should be planned following the new resectability classification. In this article, clinical guidelines of pancreatic cancer in the United States, Europe and Japan have been summarized and large cohort studies, phase I, II trials and meta-analyses have been reviewed concerning neoadjuvant therapy for pancreatic cancer.