Neoadjuvant chemotherapy in borderline resectable pancreatic cancer: A case report

Palmarocchi, Maria Celeste; Canger, Ruben Carlo Balzarotti; Saletti, Piercarlo

doi:10.3892/ol.2017.6026

Cited by 5 publications

(3 citation statements)

References 91 publications

(93 reference statements)

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“…The patient underwent duodenopancreatectomy and displayed pCR on final pathology. The patient refused adjuvant therapy and unfortunately had recurrence after 4 months from the surgery 14. A similar case was reported by Pozza et al of a patient who achieved pCR following pancreatectomy after five cycles of FOLFIRINOX, but later developed multiple brain metastasis 15.…”

Section: Discussionsupporting

confidence: 73%

Pathological complete response in pancreatic adenocarcinoma with FOLFIRINOX

Kao

Aziz

Kasi³

2018

BMJ Case Reports

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The report describes a patient who presented to our centre with abdominal pain and significant weight loss due to adenocarcinoma of the tail of the pancreas. The cancer was deemed as 'resectable disease associated with morbid surgical outcomes' due to the local involvement of the vessels and adjacent organs. Given the patient's excellent performance status, the patient underwent neoadjuvant chemotherapy with folinic acid, fluorouracil, irinotecan and oxaliplatin to downstage the tumour for less morbid surgical resection. The patient underwent 12 cycles of chemotherapy with serial imaging which demonstrated positive response to treatment and surgical resection was performed. Surgical pathology revealed no residual tumour and imaging was negative for any extrapancreatic tumour metastasis. This is an unusual case as pancreatic malignancy is usually lethal with poor survival outcomes.

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Section: Discussionsupporting

confidence: 73%

Pathological complete response in pancreatic adenocarcinoma with FOLFIRINOX

Kao

Aziz

Kasi³

2018

BMJ Case Reports

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“…1). 6–17,20–41 The level of evidence was graded as level 4 in all included studies. The descriptive characteristics of the included patients are illustrated in Table 1 and crude individual patients' data are shown in Table S1.…”

Section: Resultsmentioning

confidence: 99%

Pathological complete response after neoadjuvant therapy for pancreatic ductal adenocarcinoma does not equal cure

Zhou

Liao

You

2021

ANZ Journal of Surgery

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Background There is a scarcity of data about patients with pancreatic ductal adenocarcinoma (PDAC) who received neoadjuvant therapy before radical resection and achieved a pathological complete response (pCR). The aim of this study was to describe the recurrence and survival in this subset of patients. Methods The Embase, Web of Science and PubMed databases were systematically searched for eligible studies published between January 2000 and August 2020. Clinicopathological data of individual patients with pCR after neoadjuvant therapy for PDAC were extracted, pooled and analysed. Results A total of 87 patients were subject to analysis. The majority of patients were female (61.5%) with a median age of 64 (range 43–75) years. Among reported, 41.9% of patients received gemcitabine‐based neoadjuvant chemotherapy, 33.7% received FOLFIRINOX (5‐fluorouracil, oxaliplatin, irinotecan and leucovorin)‐based regimen and 24.4% received fluoropyrimidine drugs‐based regimen. Preoperative radiation was administered to 78.8% of the patients. Twenty‐nine (33.3%) patients developed disease recurrence during a median follow‐up period of 22.4 (range 2–194) months. The median, 1‐, 3‐ and 5‐year overall survival rates were 105 months, 93.6%, 70.3% and 70.3%, respectively. Conclusion Despite the excellent long‐term outcomes, a pCR does not equal cure because this cohort of patients still has a significant risk of recurrence.

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“…In the other hand, FOLFIRINOX has been studied as neoadjuvant option for locally advanced and borderline resectable patients [63][64][65] . The neoadjuvant therapy can benefit by converting a few locally advanced tumors into resectable ones and increase R0 resectability in borderline tumors [66,67] .…”

Section: Folfirinox Regimen -Fluorouracil Leucovorin Irinotecan Andmentioning

confidence: 99%

Pancreatic cancer: treatment approaches and trends

Pereira¹,

Corrêa²

2018

JCMT

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Pancreatic cancer is one of the most challenging diseases due to its often late diagnose which results in limited therapeutic options and poor prognosis. To date, the only curative treatment is complete tumor removal surgery but only a few patients are eligible to do it. The median survival period after surgery followed by chemotherapy adjuvant treatment is about 2 years. Since its approval by the FDA, Gemcitabine has become the first-line chemotherapy agent for treatment of advanced pancreatic cancer. The FOLFIRINOX regimen is also used as a treatment scheme for pancreatic cancer; however, this regimen has resulted in small improvements in overall patient's survival. It is appropriated to clarify that the FOLFIRINOX regimen can only be administered in patients with good performance status. Due to the absence of outstanding result after patient's treatment with diverse chemotherapeutic agents combinations or unsuccessful administration of single-agent drugs to treat pancreatic cancer, the immunotherapy has become a new hope. A more comprehensive understanding of cancer microenvironment and the chemical communication between cancer cells and immune cells can result in new therapeutic approaches that will improve the elimination of pancreatic cancer cells, enhancing life quality for these patients and increasing the overall survival.

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Neoadjuvant chemotherapy in borderline resectable pancreatic cancer: A case report

Cited by 5 publications

References 91 publications

Pathological complete response in pancreatic adenocarcinoma with FOLFIRINOX

Pathological complete response in pancreatic adenocarcinoma with FOLFIRINOX

Pathological complete response after neoadjuvant therapy for pancreatic ductal adenocarcinoma does not equal cure

Pancreatic cancer: treatment approaches and trends

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