Multidisciplinary neoadjuvant management for potentially curable pancreatic cancer

Cancer Medicine

Neelam V. Desai¹  Sarunas Sliesoraitis¹  Steven J. Hughes⁴  Jose G. Trevino⁴  Robert A. Zlotecki²  Alison M. Ivey³ 

[1] Division of Hematology and Oncology, Department of Medicine, University of Florida, Gainesville, Florida;Department of Radiation Oncology, University of Florida, Gainesville, Florida;University of Florida Health Cancer Center, Gainesville, Florida;Department of Surgery, University of Florida, Gainesville, Florida

关键词: Chemotherapy;    neoadjuvant;    pancreatic cancer;    personalized oncology;    radiation;    surgery;   

DOI  :  10.1002/cam4.444

来源: Wiley

【 摘 要 】

Abstract

Pancreatic adenocarcinoma remains the fourth leading cause of cancer mortality in the U.S. Despite advances in surgical technique, radiotherapy technologies, and chemotherapeutics, the 5-year survival rate remains approximately 20% for the 15% of patients who are eligible for surgical resection. The majority of this group suffers metastatic recurrence. However, despite advances in therapies for patients with advanced pancreatic cancer, only surgery has consistently proven to improve long-term survival. Various combinations of chemotherapy, biologic-targeted therapy, and radiotherapy have been evaluated in different settings to improve outcomes. In this context, a neoadjuvant (preoperative) treatment strategy offers numerous potential benefits: (1) ensuring delivery of early, systemic therapy, (2) improving selection of patients for surgical therapy with truly localized disease, (3) potential downstaging of the neoplasm facilitating a negative margin resection in patients with locally advanced disease, and (4) providing a superior clinical trial mechanism capable of rapid assessment of the efficacy of novel therapeutics. This article reviews the recent trends in the management of pancreatic adenocarcinoma, with a particular emphasis on a multidisciplinary neoadjuvant approach to treatment.

【 授权许可】

CC BY   
© 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.