Nab-paclitaxel plus gemcitabine versus nab-paclitaxel plus gemcitabine followed by FOLFIRINOX induction chemotherapy in locally advanced pancreatic cancer (NEOLAP-AIO-PAK-0113): a multicentre, randomised, phase 2 trial

Thumbprinting Locally Advanced Pancreatic Cancer: Have We Developed the Optimal Staging System?

“…In the NEOLAP phase II trial, the resection rate following induction chemotherapy for LAPC-defined using imaging criteria, surgical exploration, or both-was 32%. 3 Obvious staging bias notwithstanding, this resection rate is among the highest for patients with LAPC ever reported in the literature. 3 Resection rates reported in other major trials include \ 5% in the LAP07 trial and SCALOP trial and 15% in the LAPACT trial.…”

“…3 Obvious staging bias notwithstanding, this resection rate is among the highest for patients with LAPC ever reported in the literature. 3 Resection rates reported in other major trials include \ 5% in the LAP07 trial and SCALOP trial and 15% in the LAPACT trial. [9][10][11] And, while patients who undergo R0 resection may enjoy longevity, patients in whom margins are positive may not.…”

“…In the NEOLAP trial, for example, the median overall survival of patients who underwent R0 pancreatectomy was 40 months, but the median overall survival of patients who underwent R1 pancreatectomy, which occurred in [ 30% of operations, was similar to that of patients who did not undergo pancreatectomy at all. 3 Although surgery can and should be considered in highly selected patients following induction chemotherapy and/or (chemo)radiation therapy, these data emphasize that surgical resection should not be considered the goal of therapy for patients with LAPC (or, we would argue, for patients with any stage of pancreatic cancer). The goals, instead, should be longevity and quality of life.…”

“…1,2 Increasingly, however, multidisciplinary teams have recognized a potential role for pancreatectomy in patients with LAPC who have a robust physiologic profile and radiographically localized disease following induction chemotherapy and/or (chemo)radiation. 3 A nuanced staging system that acknowledges the clinical heterogeneity within LAPC has yet to be widely adopted.…”

[18F]FDG PET/MRI enables early chemotherapy response prediction in pancreatic ductal adenocarcinoma

“…Particularly in locally advanced pancreatic cancer (LAPC) early chemotherapeutic response assessment is of utmost importance to enable identification of responders, i.e. resectability [ 20 ].…”