Research and guidelines interpretation of neoadjuvant therapy for resectable pancreatic cancer, promising or limited?

doi:10.16139/j.1007-9610.2024.01.01

Abstract

Abstract:

As a systemic disease, pancreatic cancer is highly malignant and has a high rate of recurrence and metastasis, which makes it particularly difficult in diagnosis, treatment and management. In recent years, with the concept of neoadjuvant therapy deeply rooted in the hearts of the people, the treatment of pancreatic cancer has increasingly emphasized the development of comprehensive and individualized treatment schemes in the whole process and multi-dimensional management of pancreatic cancer patients. However, there still remain many controversies about the application of neoadjuvant therapy for resectable pancreatic cancer. This review intended to discuss the hot topics and related controversies in the implementation of neoadjuvant therapy for patients with resectable pancreatic cancer based on domestic and foreign guidelines and the latest research progress, which may vastly promote the standardized application of neoadjuvant therapy for resectable pancreatic cancer.

Key words: Resectable pancreatic cancer, Neoadjuvant therapy, Progress and controversies, Standardized treatment

CLC Number:

R735.9

ZHANG Taiping, WENG Guihu, LIU Yueze. Research and guidelines interpretation of neoadjuvant therapy for resectable pancreatic cancer, promising or limited?[J]. Journal of Surgery Concepts & Practice, 2024, 29(01): 1-4.

References 20

[1]	SPRINGFELD C, FERRONE C R, KATZ M H G, et al. Neoadjuvant therapy for pancreatic cancer[J]. Nat Rev Clin Oncol, 2023, 20(5):318-337. doi: 10.1038/s41571-023-00746-1 pmid: 36932224
[2]	孟令威, 吴仲, 彭兵. 胰腺癌新辅助化疗后的微创治疗[J]. 中国普外基础与临床杂志, 2023, 30(9):1025-1029.
	MENG L W, WU Z, PENG B. Minimally invasive treatment of pancreatic cancer after neoadjuvant chemotherapy[J]. Chin J Bases Clin Gen Surg, 2023, 30(9):1025-1029
[3]	VERSTEIJNE E, VAN DAM J L, SUKER M, et al. Neoadjuvant chemoradiotherapy versus upfront surgery for resectable and borderline resectable pancreatic cancer: long-term results of the dutch randomized PREOPANC trial[J]. J Clin Oncol, 2022, 40(11):1220-1230.
[4]	SEUFFERLEIN T, UHL W, KORNMANN M, et al. Perioperative or only adjuvant gemcitabine plus nab-paclitaxel for resectable pancreatic cancer (NEONAX) — a randomized phase Ⅱ trial of the AIO pancreatic cancer group[J]. Ann Oncol, 2023, 34(1):91-100.
[5]	SOHAL D P S, DUONG M, AHMAD S A, et al. Efficacy of perioperative chemotherapy for resectable pancreatic adenocarcinoma: a phase 2 randomized clinical trial[J]. JAMA Oncol, 2021, 7(3):421-427. doi: 10.1001/jamaoncol.2020.7328 pmid: 33475684
[6]	USON JUNIOR P L S, DIAS E SILVA D, DE CASTRO N M, et al. Does neoadjuvant treatment in resectable pancreatic cancer improve overall survival? A systematic review and meta-analysis of randomized controlled trials[J]. ESMO Open, 2023, 8(1):100771.
[7]	杨尹默, 田孝东. 中国胰腺癌诊治指南(2021)[J]. 中国实用外科杂志, 2021, 41(7):725-738.
	YANG Y M, TIAN X D. Chinese guidelines for diagnosis and treatment of pancreatic cancer(2021)[J]. Chin J Pract Surg, 2021, 41(7):725-738.
[8]	TEMPERO M A, MALAFA M P, AL-HAWARY M, et al. Pancreatic adenocarcinoma, version 2.2021, NCCN clinical practice guidelines in oncology[J]. J Natl Compr Canc Netw, 2021, 19(4):439-457.
[9]	WU V S, ELSHAMI M, STITZEL H J, et al. Why the treatment sequence matters: interplay between chemotherapy cycles received, cumulative dose intensity, and survival in resected early-stage pancreas cancer[J]. Ann Surg, 2023, 278(4):e677-e684.
[10]	ZOU Y, GAO S, YU X, et al. Survival outcomes of neoadjuvant therapy followed by radical resection versus upfront surgery for stage Ⅰ-Ⅲ pancreatic ductal adenocarcinoma: a retrospective cohort study[J]. Int J Surg, 2023, 109(6):1573-1583.
[11]	STRICKLER J H, SATAKE H, GEORGE T J, et al. Sotorasib in KRAS p.G12C-mutated advanced pancreatic cancer[J]. N Engl J Med, 2023, 388(1):33-43.
[12]	BEKAII-SAAB T S, YAEGER R, SPIRA A I, et al. Adagrasib in advanced solid tumors harboring a KRASG12C mutation[J]. J Clin Oncol, 2023, 41(25):4097-4106.
[13]	KING D, KAMRAN U, DOSANJH A, et al. Rate of pancreatic cancer following a negative endoscopic ultrasound and associated factors[J]. Endoscopy, 2022, 54(11):1053-1061. doi: 10.1055/a-1784-1661 pmid: 35359019
[14]	SAGAMI R, NAKAHODO J, MINAMI R, et al. True diagnostic ability of EUS-guided fine-needle aspiration/biopsy sampling for small pancreatic lesions ≤10 mm and salvage diagnosis by pancreatic juice cytology: a multicenter study[J]. Gastrointest Endosc, 2024, 99(1):73-80.
[15]	VAN EIJCK C W F, MUSTAFA D A M, VADGAMA D, et al. Enhanced antitumour immunity following neoadjuvant chemoradiotherapy mediates a favourable prognosis in women with resected pancreatic cancer[J]. Gut, 2024, 73(2):311-324.
[16]	NAKAJIMA K, INO Y, NAITO C, et al. Neoadjuvant therapy alters the collagen architecture of pancreatic cancer tissue via Ephrin-A5[J]. Br J Cancer, 2022, 126(4):628-639.
[17]	BYRNE K T, BETTS C B, Mick R, et al. Neoadjuvant selicrelumab, an agonist CD40 antibody, induces changes in the tumor microenvironment in patients with resectable pancreatic cancer[J]. Clin Cancer Res, 2021, 27(16):4574-4586. doi: 10.1158/1078-0432.CCR-21-1047 pmid: 34112709
[18]	REDEGALLI M, GRASSINI G, MAGLIACANE G, et al. Routine molecular profiling in both resectable and unresectable pancreatic adenocarcinoma: relevance of cytologic samples[J]. Clin Gastroenterol Hepatol, 2023, 21(11):2825-2833.
[19]	ECKER B L, TAO A J, JANSSEN Q P, et al. Genomic biomarkers associated with response to induction chemotherapy in patients with localized pancreatic ductal adenocarcinoma[J]. Clin Cancer Res, 2023, 29(7):1368-1374.
[20]	ZHOU X, AN J, KURILOV R, et al. Persister cell phenotypes contribute to poor patient outcomes after neoadjuvant chemotherapy in PDAC[J]. Nat Cancer, 2023, 4(9):1362-1381.