ASO Author Reflections: Adjuvant Therapy for Resectable Pancreatic Cancer in the Real World—Not as Common as One Might Think

Excerpt

Any good prognosis of patients with pancreatic cancer (PC) passes through a combination of surgery and chemotherapy. For nonresectable, nonmetastatic patients, the therapeutic journey has historically been represented by chemotherapy, and hopefully, surgery. However, for resectable PC, this sequential approach has been challenged by neoadjuvant therapy in recent years.¹ Since the European Study Group of Pancreatic Cancer (ESPAC) trials, adjuvant chemotherapy (AT) has become the gold standard after upfront resection of resectable PC. These trials focused on the type, schedule, and survival advantages of the different types of chemotherapy. These clinical trials are based on the obviousness that patients access AT. However, clinical trials may not correspond to the real world and the percentage of patients accessing AT has been reported to range from 30% to 50 %.² This ultimately results in half of patients missing the opportunity to complete multimodal PC treatment. In contrast, more than three-quarters of patients with resectable PC receiving neoadjuvant therapy first undergo surgery.³ …