Role of Neoadjuvant Therapy in Management of Pancreatic Cancer

  • Jia Li VA Connecticut Healthcare System, Yale Cancer Center. New Haven, CT, USA
  • Muhammad Wasif Saif Tufts Cancer Center. Boston, MA, USA
Keywords: Chemoradiotherapy, Neoadjuvant Therapy, Pancreatic Neoplasms

Abstract

Surgery remains the only curative treatment for pancreatic cancer; however, majority of patients present with advanced unresectable disease upon diagnosis. Treatment of nonmetastatic, locally advanced pancreatic cancer (LAPC) continues to require multidisciplinary bimodality or trimodality approach. Neoadjuvant therapies have been investigated for LAPC given its established role in other solid cancers such as breast cancer, gastric cancer, and rectal cancer. This strategy is now moving forward to management of potentially resectable disease as well. This meeting highlight focuses on recent updates on neoadjuvant therapy for both borderline resectable disease and potentially resectable disease, Abstracts #4120, #e15189, #e15226 and #TPS4158 will be discussed.

Image: Yale Cancer Center. New Haven, CT, USA.

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References

Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. Cancer J Clin. 2014, 64(1): 9.

Oettle H, Post S, Neuhaus P, Gellert K, Langrehr J, Ridwelski K, Schramm H, et al. Adjuvant chemotherapy with gemcitabine vs observation in patients undergoing curative-intent resection of pancreatic cancer: a randomized controlled trial. JAMA. 2007; 297: 267. [PMID:17227978]

Burris HA 3rd, Moore MJ, Andersen J, Green MR, Rothenberg ML, Modiano MR, Cripps MC, et al. Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol. 1997; 15: 2403. [PMID:9196156]

Conroy T, Desseigne F, Ychou M, Bouché O, Guimbaud R, Bécouarn Y, Adenis A, et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med. 2011; 364: 1817. [PMID:21561347]

Von Hoff DD, Ervin T, Arena FP, Chiorean EG, Infante J, Moore M, Seay T, et al. Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med. 2013; 369(18): 1691-703. [PMID:24131140]

Seufferlein T, Bachet JB, Van Cutsem E, Rougier P; ESMO Guidelines Working Group. Pancreatic adenocarcinoma: ESMO-ESDO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2012; 23 Suppl 7: vii33-40. [PMID:22997452]

National Comprehensive Cancer Network (NCCN). NCCN Clinical practice guidelines in oncology. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp

Huguet F, André T, Hammel P, Artru P, Balosso J, Selle F, Deniaud-Alexandre E, et al. Impact of chemoradiotherapy after disease control with chemotherapy in locally advanced pancreatic adenocarcinoma in GERCOR phase II and III studies. J Clin Oncol. 2007; 25: 326. [PMID:17235048]

Ishii H, Furuse J, Boku N, Okusaka T, Ikeda M, Ohkawa S, Fukutomi A, et al. Phase II study of gemcitabine chemotherapy alone for locally advanced pancreatic carcinoma: JCOG0506. Jpn J Clin Oncol. 2010; 40: 573. [PMID:20185458]

Sahora K, Kuehrer I, Eisenhut A, Akan B, Koellblinger C, Goetzinger P, Teleky B, et al. NeoGemOx: Gemcitabine and oxaliplatin as neoadjuvant treatment for locally advanced, nonmetastasized pancreatic cancer. Surgery. 2011; 149: 311. [PMID:20817204]

Motoi F, Ishida K, Fujishima F, Ottomo S, Oikawa M, Okada T, Shimamura H, et al. Neoadjuvant chemotherapy with gemcitabine and S-1 for resectable and borderline pancreatic ductal adenocarcinoma: results from a prospective multi-institutional phase 2 trial. Ann Surg Oncol. 2013; 20: 3794. [PMID:23838925]

Faris JE, Blaszkowsky LS, McDermott S, Guimaraes AR, Szymonifka J, Huynh MA, Ferrone CR, et al. FOLFIRINOX in locally advanced pancreatic cancer: the Massachusetts General Hospital Cancer Center experience. Oncologist. 2013; 18: 543. [PMID:23657686]

Boone BA, Steve J, Krasinskas AM, Zureikat AH, Lembersky BC, Gibson MK, et al. Outcomes with FOLFIRINOX for borderline resectable and locally unresectable pancreatic cancer. J Surg Oncol 2013; 108: 236. [PMID:17227978]

Gunturu KS, Yao X, Cong X, Thumar JR, Hochster HS, Stein SM, Lacy J. FOLFIRINOX for locally advanced and metastatic pancreatic cancer: single institution retrospective review of efficacy and toxicity. Med Oncol. 2013; 30: 361. [PMID:23271209]

Cardenes HR, Moore AM, Johnson CS, Yu M, Helft P, Chiorean EG, Vinson J, et al. A phase II study of gemcitabine in combination with radiation therapy in patients with localized, unresectable, pancreatic cancer: a Hoosier Oncology Group study. Am J Clin Oncol. 2011; 34: 460. [PMID:20881474]

Li CP, Chao Y, Chi KH, Chan WK, Teng HC, Lee RC, Chang FY, et al. Concurrent chemoradiotherapy treatment of locally advanced pancreatic cancer: gemcitabine versus 5-fluorouracil, a randomized controlled study. Int J Radiat Oncol Biol Phys. 2003; 57: 98. [PMID:12909221]

Loehrer PJ Sr, Feng Y, Cardenes H, Wagner L, Brell JM, Cella D, Flynn P, et al. Gemcitabine alone versus gemcitabine plus radiotherapy in patients with locally advanced pancreatic cancer: an Eastern Cooperative Oncology Group trial. J Clin Oncol. 2011, 29: 4105. [PMID:21969502]

Katz MH, Pisters PW, Evans DB, Sun CC, Lee JE, Fleming JB, Vauthey JN, et al. Borderline resectable pancreatic cancer: the importance of this emerging stage of disease. J Am Coll Surg. 2008; 206: 833. [PMID:18471707]

Coveler AL, Pillarisetty VG, Gyurkey G, Koh WJ, Upton M, Cuevas C, et al. A phase II study of perioperative therapy for patients with resectable and borderline-resectable pancreatic adenocarcinoma. J Clin Oncol 32: 5s, 2014; (suppl, abstr 4120).

Ettrich TJ, Berger AW, Muche R, Lutz MP, Prasnikar N, Uhl W, et al. NEONAX: Neoadjuvant plus adjuvant or only adjuvant nab-paclitaxel plus gemcitabine for resectable pancreatic cancer - A phase II study of the AIO Pancreatic Cancer Group. J Clin Oncol. 32: 5s, 2014; (suppl, abstr TPS4158).

James ES, Yao X, Cong X, Li J, Hahn C, Kaley K, et al. Interim analysis of a phase II study of dose-modified FOLFIRINOX (mFOLFIRINOX) in locally advanced (LAPC) and metastatic pancreatic cancer (MPC). J Clin Oncol. 32, 2014; (suppl, abstr e15226).

Mody K, Shatzel JJ, James SL, Wang R, Colacchio TA, Barth RJ, et al. Prognostic value of serum carbohydrate 19-9 in patients receiving gemcitabine-based neoadjuvant therapy for pancreatic cancer. J Clin Oncol. 32, 2014; (suppl, abstr e15189).

Yale Cancer Center. New Haven, CT, USA
Published
2014-07-28
How to Cite
LiJ., & SaifM. (2014). Role of Neoadjuvant Therapy in Management of Pancreatic Cancer. JOP. Journal of the Pancreas, 15(4), 354-357. https://doi.org/10.6092/1590-8577/2695
Section
Highlights from the “50th ASCO Annual Meeting 2014”. Chicago, IL, USA. May 30 - June 3, 2014