A phase II study of gemcitabine/nab-paclitaxel/S-1 combination neoadjuvant chemotherapy for patients with borderline resectable pancreatic cancer with arterial contact

Kondo, Naru; Uemura, Kenichiro; Sudo, Takeshi; Hashimoto, Yasushi; Sumiyoshi, Tatsuaki; Okada, Kenjiro; Seo, Shingo; Otsuka, Hiroyuki; Murakami, Yoshiaki; Takahashi, Shinya

doi:10.1016/j.ejca.2021.10.012

Cited by 21 publications

(15 citation statements)

References 24 publications

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“…In early phase II trials, combinatorial therapy using GNP with S-1 has been associated with improved survival. Kondo et al [28 ▪ ] conducted a single-arm, multicenter phase II study with BR-PDAC with NAT using six cycles of GNP and S-1. Primary end-point was 2-year OS and secondary end-points were overall response rate, treatment toxicity, resection rate, R0 resection rate, PFS, and pathologic response.…”

Section: Other Neoadjuvant Strategiesmentioning

confidence: 99%

Neoadjuvant therapy in pancreatic cancer: a review and update on recent trials

Zureikat

2022

Current Opinion in Gastroenterology

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Purpose of reviewNeoadjuvant therapy (NAT) has been enthusiastically embraced for patients with operable pancreatic cancer (PDAC) in hopes of improving survival. However, the rapid integration of clinical trial data has made it difficult to discern optimal treatment strategies. The goal of this review is to summarize notable recent trials and their contributions to the field.Recent findingsThe results of ESPAC-5F, NEOLAP-AIO-PAK-0113, SWOG1505, PREOPANC, HyperAcutePancreas, and ALLIANCE A021501 are reviewed in detail. These studies sequentially evaluate the different neoadjuvant treatment strategies, use of neoadjuvant chemoradiation, and immunotherapy in resectable, borderline-resectable, and locally advanced PDAC. Resection rate ranged from 24.4 to 95.7% (median 64.9%). These trials demonstrate median survival ranging from 14.9 to 41.0 months with progression-free survival ranging from 7.7 to 24.2 months. Survival results may be confounded by ability to reach resection, use of modern chemotherapy vs. gemcitabine monotherapy, and inclusion of locally advanced PDAC. Several upcoming trials will directly examine efficacy of NAT vs. adjuvant therapy, chemoradiation in the NAT setting, and molecular testing-driven chemotherapy selection.SummaryNAT is associated with improved survival for patients with borderline resectable PDAC but broader efficacy for resectable PDAC and optimal treatment strategy have yet to be defined.

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Section: Other Neoadjuvant Strategiesmentioning

confidence: 99%

Neoadjuvant therapy in pancreatic cancer: a review and update on recent trials

Zureikat

2022

Current Opinion in Gastroenterology

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“…More intensive and prolonged treatment may be necessary for BR-A than BR-PV. A multicenter single-arm phase II trial 101 was performed to evaluate the NAC-GAS clinical efficacy and safety (including GEM, nab-paclitaxel, and S-1) in 47 eligible patients with BR-A in 2021. The grade III/IV toxicity rates occurred in 30% of patients during the GAS regimen, whereas R0 resection was 86%, and primary endpoints of the 2-year OS rate and median OS duration were 70.1% and 41.0 months, respectively, indicating good efficacy.…”

Section: Future Prospectsmentioning

confidence: 99%

Neoadjuvant and Adjuvant Treatments for Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinoma: The Current Status of Pancreatic Ductal Adenocarcinoma Treatment in Japan

Takahashi

Ogasawara

et al. 2023

Gut and Liver

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Resection is the only curative treatment for pancreatic ductal adenocarcinoma (PDAC). Although the outcome of technically resectable PDAC has improved with advances in surgery and adjuvant therapy, the 5-year survival rate remains low at 20% to 40%. More effective therapy is needed. Almost 15 years ago, the National Comprehensive Cancer Network guidelines proposed a resectability classification of PDAC based on preoperative imaging. Since then, treatment strategies for PDAC have been devised based on resectability. The standard of care for resectable PDAC is adjuvant chemotherapy after R0 resection, as shown by the results of pivotal clinical trials. With regard to neoadjuvant treatment, several recent clinical trials comparing neoadjuvant treatment with upfront resection have been conducted on resectable PDAC and borderline resectable PDAC, and the benefits and efficacy of neoadjuvant treatment for pancreatic cancer has become clearer. The significance of neoadjuvant treatment for resectable PDAC remains controversial, but in borderline resectable PDAC the efficacy of neoadjuvant treatment has been further recognised, although the standard of care has not yet been established. Several promising clinical trials for PDAC are ongoing. This review presents previous and ongoing trials of perioperative treatment for resectable and borderline resectable PDAC, focusing on the difference between Asian and Western countries.

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“…A phase 2 LAPACT trial evaluated the efficacy of neoadjuvant GA administered in six cycles to 107 patients with LAPC and showed an ORR of 33.6% and a median OS of 18.8 months, although conversion surgery was performed in only 27 patients (resection rate: 25.2%) (32). Another phase 2 trial evaluated the efficacy of adding S-1 to the GA regimen for the treatment of patients with BRPC and arterial contact (35). In 47 patients who received six cycles of GA plus S-1 regimen, the ORR was 46%, with an R0 resection rate of 86% and a median OS of 41.0 months (35).…”

Section: Neoadjuvant Chemotherapymentioning

confidence: 99%

“…Another phase 2 trial evaluated the efficacy of adding S-1 to the GA regimen for the treatment of patients with BRPC and arterial contact (35). In 47 patients who received six cycles of GA plus S-1 regimen, the ORR was 46%, with an R0 resection rate of 86% and a median OS of 41.0 months (35).…”

Section: Neoadjuvant Chemotherapymentioning

confidence: 99%

Current status and future perspective of neoadjuvant therapy in locally advanced and borderline resectable pancreatic adenocarcinoma: a narrative review

Hyung¹,

Lee²,

Hwang³

et al. 2022

Chin Clin Oncol

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Background and Objective: The concept of neoadjuvant approach for patients with locally advanced pancreatic cancer (LAPC) has been evolving with the advancement in therapeutic modalities. In this narrative review, we aimed to discuss the updates and future perspectives on the treatment of LAPC. Methods:We discussed the recent literature and up-to-date evidence along with the future perspectives for the treatment of LAPC using the neoadjuvant approach. Reviewed literatures were searched by systematic search of PubMed and Google Scholar, including articles published in English between January 1st, 2013, and October 31st, 2021.

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A phase II study of gemcitabine/nab-paclitaxel/S-1 combination neoadjuvant chemotherapy for patients with borderline resectable pancreatic cancer with arterial contact

Cited by 21 publications

References 24 publications

Neoadjuvant therapy in pancreatic cancer: a review and update on recent trials

Neoadjuvant therapy in pancreatic cancer: a review and update on recent trials

Neoadjuvant and Adjuvant Treatments for Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinoma: The Current Status of Pancreatic Ductal Adenocarcinoma Treatment in Japan

Current status and future perspective of neoadjuvant therapy in locally advanced and borderline resectable pancreatic adenocarcinoma: a narrative review

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