Multidisciplinary management of locally advanced pancreatic adenocarcinoma: Biology is King

J Surg Oncol. 2021 May;123(6):1395-1404. doi: 10.1002/jso.26415.

Abstract

The annual incidence of pancreatic cancer is nearly 50,000 patients. The 5-year overall survival is only 9%, and there remains a great need for better therapy. A subset of these patients presents with locally advanced disease. Multidisciplinary therapy has evolved to include some combination of systemic chemotherapy, locoregional radiation, and surgery in select patients with excellent biology. This review will address the thoughtful evidence-based and individualized approach to these patients.

Keywords: irreversible electroporation; locally advanced pancreatic cancer; total neoadjuvant therapy.

Publication types

  • Review

MeSH terms

  • Albumins / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carcinoma, Pancreatic Ductal / pathology
  • Carcinoma, Pancreatic Ductal / surgery
  • Carcinoma, Pancreatic Ductal / therapy*
  • Chemoradiotherapy
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives
  • Disease Management
  • Evidence-Based Medicine
  • Fluorouracil / administration & dosage
  • Gemcitabine
  • Humans
  • Irinotecan / administration & dosage
  • Leucovorin / administration & dosage
  • Neoadjuvant Therapy
  • Oxaliplatin / administration & dosage
  • Paclitaxel / administration & dosage
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery
  • Pancreatic Neoplasms / therapy*
  • Precision Medicine

Substances

  • 130-nm albumin-bound paclitaxel
  • Albumins
  • folfirinox
  • Oxaliplatin
  • Deoxycytidine
  • Irinotecan
  • Paclitaxel
  • Leucovorin
  • Fluorouracil
  • Gemcitabine