Given the updated results of the PREOPANC study, how can gemcitabine-based neoadjuvant chemoradiation be best incorporated into the treatment of resectable or borderline resectable pancreatic cancer?
If multi-agent systemic therapy, i.e. FOLFIRINOX, is also planned, is there a preferred sequence of therapies?
Answer from: Radiation Oncologist at Community Practice
The PREOPANC-1 trial and the study by Jang et al., PMID 29462005 are currently the only 2 published randomized trials comparing pre-op CRT vs up-front surgery for resectable/borderline resectable PDAC- each of which has now demonstrated an overall survival benefit. The obvious critique is the standa...
Answer from: Medical Oncologist at Community Practice
The results of PREOPANC, although powerful, is unlikely to change the current common practice of at least a segment of neoadjuvant therapy for PDAC (with CRT component when appropriate based on multidisciplinary discussion).In addition to the nature of the chemotherapy in both arms, there were 2 mai...