The Fate of Resectable Pancreatic Adenocarcinoma after Neoadjuvant Chemotherapy

Ahmer Irfan, J. Bart Rose, Thomas N. Wang, Selwyn M. Vickers, Vikas Dudeja, Olumide Gbolahan, Sushanth Reddy

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives Pancreatic cancer continues to be a major cause of cancer-related mortality. There has been a greater implementation of up-front chemotherapy for pancreatic adenocarcinoma patients. Although there are many theoretical benefits to neoadjuvant chemotherapy, its clinical impact is uncertain. We sought to understand the outcomes of patients with resectable and borderline-resectable pancreatic adenocarcinoma who underwent neoadjuvant chemotherapy. Methods Patients were collected in a secure database from September 2018 to May 2020. Patients were excluded if they presented with locally advanced or metastatic disease, inability to complete chemotherapy, or if they were not a surgical candidate. Results Sixty-six patients with resectable disease underwent chemotherapy. Folinic acid/5-fluorouracil/irinotecan/oxaliplatin was used in 41 patients (62.1%) and gemcitabine-based regimens in 28 patients (42.4%, greater than 100% as some patients underwent both regimens). After restaging, 47 patients (71.2%) were thought to have resectable disease. Of these patients, 36 have been successfully resected to date. Metastatic disease was found in 12 patients (18.2%) and 6 patients (9.1%) had locally advanced disease. Conclusions Most patients with resectable pancreatic cancer are resected after neoadjuvant chemotherapy, but a subset will develop local or distant progression. Further studies will be needed to determine which patients will progress locally and may benefit from an up-front surgical approach.

Original languageEnglish (US)
Pages (from-to)100-105
Number of pages6
JournalPancreas
Volume51
Issue number1
DOIs
StatePublished - Jan 1 2022
Externally publishedYes

Keywords

  • Neoadjuvant chemotherapy
  • Outcomes
  • Pancreatic adenocarcinoma

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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