Neoadjuvant Therapy for Resectable Pancreatic Adenocarcinoma

Abstract

For the subset of patients with pancreatic cancer who have been deemed to have resectable disease at the time of diagnosis, complete surgical resection offers the only chance of long-term cure. More recently, the addition of adjuvant therapy has been shown to offer a survival advantage over those patients who undergo resection alone, and multimodality therapy represents the widely accepted treatment paradigm. Neoadjuvant therapy in the setting of a multimodality approach to treating resectable pancreatic head adenocarcinoma may allow for: (1) early treatment of occult micometastatic disease and testing of the biology of the tumor to minimize the risk of unnecessary surgical resection in patients who would not benefit from surgery, (2) increasing the rate of margin negative resections, (3) increasing the likelihood of completing adjuvant therapy, and (4) possibly reducing surgical morbidity.