Cassese G, Han HS, Yoon YS, Lee JS, Lee B, Cubisino A, Panaro F, Troisi RI. Role of neoadjuvant therapy for nonmetastatic pancreatic cancer: Current evidence and future perspectives. World J Gastrointest Oncol 2023; 15(6): 911-924 [PMID: 37389109 DOI: 10.4251/wjgo.v15.i6.911]
Corresponding Author of This Article
Ho-Seong Han, MD, Professor, Department of Surgery, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam 13620, Gyeonggi-do, South Korea. hanhs@snubh.org
Research Domain of This Article
Surgery
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Jun 15, 2023; 15(6): 911-924 Published online Jun 15, 2023. doi: 10.4251/wjgo.v15.i6.911
Role of neoadjuvant therapy for nonmetastatic pancreatic cancer: Current evidence and future perspectives
Gianluca Cassese, Ho-Seong Han, Yoo-Seok Yoon, Jun Suh Lee, Boram Lee, Antonio Cubisino, Fabrizio Panaro, Roberto Ivan Troisi
Gianluca Cassese, Roberto Ivan Troisi, Department of Clinical Medicine and Surgery, Division of Minimally Invasive HPB Surgery and Transplantation Service, Federico II University Hospital, Naples 80131, Italy
Ho-Seong Han, Yoo-Seok Yoon, Jun Suh Lee, Boram Lee, Department of Surgery, Seoul National University College of Medicine, Seongnam 13620, Gyeonggi-do, South Korea
Antonio Cubisino, Department of HPB Surgery and Transplantation, Beaujon Hospital, Clichy 92110, France
Fabrizio Panaro, Department of Digestive Surgery and Liver Transplantation, CHU Montpellier, Montpellier 34100, France
Author contributions: Cassese G, Han HS, Yoon YS, and Troisi RI were responsible for the conception of the study, its draft, and final review of the manuscript; Lee B and Cubisino A were responsible for administrative support; Lee JS, and Panaro F were responsible for the final editing and review of the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ho-Seong Han, MD, Professor, Department of Surgery, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam 13620, Gyeonggi-do, South Korea. hanhs@snubh.org
Received: December 28, 2022 Peer-review started: December 28, 2022 First decision: February 16, 2023 Revised: February 17, 2023 Accepted: April 24, 2023 Article in press: April 24, 2023 Published online: June 15, 2023 Processing time: 168 Days and 9.4 Hours
Abstract
Pancreatic adenocarcinoma (PDAC) is one of the most common and lethal human cancers worldwide. Surgery followed by adjuvant chemotherapy offers the best chance of a long-term survival for patients with PDAC, although only approximately 20% of the patients have resectable tumors when diagnosed. Neoadjuvant chemotherapy (NACT) is recommended for borderline resectable pancreatic cancer. Several studies have investigated the role of NACT in treating resectable tumors based on the recent advances in PDAC biology, as NACT provides the potential benefit of selecting patients with favorable tumor biology and controls potential micro-metastases in high-risk patients with resectable PDAC. In such challenging cases, new potential tools, such as ct-DNA and molecular targeted therapy, are emerging as novel therapeutic options that may improve old paradigms. This review aims to summarize the current evidence regarding the role of NACT in treating non-metastatic pancreatic cancer while focusing on future perspectives in light of recent evidence.
Core Tip: Pancreatic adenocarcinoma (PDAC) is one of the most common and lethal human cancers worldwide; yet patients diagnosed with it still have a poor prognosis. Multimodal therapy is one of the most promising treatment options that increase the overall survival. Neoadjuvant chemotherapy (NACT) is recommended for treating borderline resectable PDAC. While recent studies have tried to explore the role of NACT in treating resectable and locally advanced PDAC, novel therapeutic modalities, such as ct-DNA and molecular targeted therapy, may guide both treatment and monitoring during the disease course to improve prognosis.
