The benefits of neoadjuvant therapy for patients with resectable pancreatic cancer: an updated systematic review and meta-analysis

Yang, Binyao; Chen, Kai; Liu, Weikang; Long, Di; Wang, Yingjin; Liu, Xinxin; Ma, Yue; Tian, Xiaodong; Yang, Yinmo

doi:10.1007/s10238-023-01112-2

Cited by 4 publications

(3 citation statements)

References 55 publications

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“…A recent study by Yang et al . 59 showed that neoadjuvant therapy effectively improved the prognosis of resectable pancreatic cancer patients. In contrast, an oral abstract session at 2023 ASCO by Labori et al .…”

Section: Clinical Advances In Neoadjuvant Immunotherapy In Gastrointe...mentioning

confidence: 99%

Neoadjuvant immunotherapy based on PD-1/L1 inhibitors for gastrointestinal tumors: a review of the rationale and clinical advances

Wang,

Liu,

Tian

et al. 2024

International Journal of Surgery

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The landscape of current tumor treatment has been revolutionized by the advent of immunotherapy based on PD-1/PD-L1 inhibitors. Leveraging its capacity to mobilize systemic anti-tumor immunity, which is primarily mediated by T cells, there is growing exploration and expansion of its potential value in various stages of clinical tumor treatment. Neoadjuvant immunotherapy induces a robust immune response against tumors prior to surgery, effectively facilitating tumor volume reduction, early eradication or suppression of tumor cell activity, and control of potential metastatic spread, to improve curative surgical resection rates and prevent tumor recurrence. This review delineates the theoretical basis of neoadjuvant immunotherapy from preclinical research evidence, discusses specific challenges in clinical application, and provides a comprehensive overview of clinical research progress in neoadjuvant immunotherapy for gastrointestinal tumors. These findings suggest that neoadjuvant immunotherapy has the potential to ameliorate immunosuppressive states and enhance cytotoxic T cell function while preserving lymphatic drainage in the preoperative period. However, further investigations are needed on specific treatment regimens, suitable patient populations, and measurable endpoints. Despite numerous studies demonstrating the promising efficacy and manageable adverse events of neoadjuvant immunotherapy in gastrointestinal tumors, the availability of high-quality randomized controlled trials is limited, which highlights the necessity for further research.

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Section: Clinical Advances In Neoadjuvant Immunotherapy In Gastrointe...mentioning

confidence: 99%

Neoadjuvant immunotherapy based on PD-1/L1 inhibitors for gastrointestinal tumors: a review of the rationale and clinical advances

Wang,

Liu,

Tian

et al. 2024

International Journal of Surgery

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“…The goal of neoadjuvant therapy is the downstaging of the tumor, which improves the likelihood of an R0 surgical resection, thereby prolonging survival rates; in this way, neoadjuvant therapy can also identify patients with rapid progression and poor response to treatment [21,22]. While the comparison between neoadjuvant and adjuvant therapies is challenging due to the different patient populations that receive these therapies, recent systematic reviews and meta-analyses underscore the benefits of neoadjuvant therapy over adjuvant therapy, including improved overall survival, higher R0 resection rates, and fewer pathological lymph nodes [23][24][25]. Further, with the literature suggesting an increasing shift towards adopting a neoadjuvant approach, numerous ongoing trials are examining the effectiveness of different neoadjuvant chemotherapy approaches, such as neoadjuvant therapy involving FOLFIRINOX, neoadjuvant therapy involving gemcitabine/nab-paclitaxel, and neoadjuvant therapy combining chemotherapy and radiation therapy [26].…”

Section: Borderline Resectable Pdacmentioning

confidence: 99%

“…is challenging due to the different patient populations that receive these therapies, recent systematic reviews and meta-analyses underscore the benefits of neoadjuvant therapy over adjuvant therapy, including improved overall survival, higher R0 resection rates, and fewer pathological lymph nodes [23][24][25]. Further, with the literature suggesting an increasing shift towards adopting a neoadjuvant approach, numerous ongoing trials are examining the effectiveness of different neoadjuvant chemotherapy approaches, such as neoadjuvant therapy involving FOLFIRINOX, neoadjuvant therapy involving gemcitabine/nab-paclitaxel, and neoadjuvant therapy combining chemotherapy and radiation therapy [26].…”

Section: Locally Advanced Pdacmentioning

confidence: 99%

CT Imaging Assessment of Pancreatic Adenocarcinoma Resectability after Neoadjuvant Therapy: Current Status and Perspective on the Use of Radiomics

Khasawneh,

Ferreira Dalla Pria,

Miranda

et al. 2023

JCM

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Pancreatic adenocarcinoma (PDAC) is the most common pancreatic cancer and is associated with poor prognosis, a high mortality rate, and a substantial number of healthy life years lost. Surgical resection is the primary treatment option for patients with resectable disease; however, only 10–20% of all patients with PDAC are eligible for resection at the time of diagnosis. In this context, neoadjuvant therapy has the potential to increase the number of patients who are eligible for resection, thereby improving the overall survival rate. For patients who undergo neoadjuvant therapy, computed tomography (CT) remains the primary imaging tool for assessing treatment response. Nevertheless, the interpretation of imaging findings in this context remains challenging, given the similarity between viable tumor and treatment-related changes following neoadjuvant therapy. In this review, following an overview of the various treatment options for PDAC according to its resectability status, we will describe the key challenges regarding CT-based evaluation of PDAC treatment response following neoadjuvant therapy, as well as summarize the literature on CT-based evaluation of PDAC treatment response, including the use of radiomics. Finally, we will outline key recommendations for the management of PDAC after neoadjuvant therapy, taking into consideration CT-based findings.

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Fragmented care in localized pancreatic cancer: Is commission on cancer accreditation associated with improved overall survival?

Park,

Verm,

Abdelsattar

et al. 2024

Surgery

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The benefits of neoadjuvant therapy for patients with resectable pancreatic cancer: an updated systematic review and meta-analysis

Cited by 4 publications

References 55 publications

Neoadjuvant immunotherapy based on PD-1/L1 inhibitors for gastrointestinal tumors: a review of the rationale and clinical advances

Neoadjuvant immunotherapy based on PD-1/L1 inhibitors for gastrointestinal tumors: a review of the rationale and clinical advances

CT Imaging Assessment of Pancreatic Adenocarcinoma Resectability after Neoadjuvant Therapy: Current Status and Perspective on the Use of Radiomics

Fragmented care in localized pancreatic cancer: Is commission on cancer accreditation associated with improved overall survival?

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