Comprehensive multimodal management of borderline resectable pancreatic cancer: Current status and progress

Abstract

Borderline resectable pancreatic cancer (BRPC) is a complex clinical entity with specific biological features. Criteria for resectability need to be assessed in combination with tumor anatomy and oncology. Neoadjuvant therapy (NAT) for BRPC patients is associated with additional survival benefits. Research is currently focused on exploring the optimal NAT regimen and more reliable ways of assessing response to NAT. More attention to management standards during NAT, including biliary drainage and nutritional support, is needed. Surgery remains the cornerstone of BRPC treatment and multidisciplinary teams can help to evaluate whether patients are suitable for surgery and provide individualized management during the perioperative period, including NAT responsiveness and the selection of surgical timing.

Neoadjuvant treatment of pancreatic ductal adenocarcinoma: Whom, when and how

“…Additionally, after 4-6 months of induction combination CHT with or without radiation therapy, 20% of patients with unresectable nonmetastatic PDAC may undergo resection, even in the absence of a discernible radiological response, improving their OS[ 35 ]. An optimal NAT regimen has not been agreed upon due to a lack of data from randomized clinical trials[ 36 ]. The two most efficient CHT regimens for PDAC are FOLFIRINOX and gemcitabine-nab-paclitaxel (GNP).…”