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Trials recruiting now, the landmark trials, the key papers and what they mean, the latest literature, and the milestones year by year.
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Together with NORPACT-1 this left the neoadjuvant question for resectable disease open: FOLFIRINOX before surgery is not proven superior to alternatives, and the comparison against upfront surgery with adjuvant modified FOLFIRINOX is what PREOPANC-3 and Alliance A021806 are running.
Supports neoadjuvant therapy, preferably chemotherapy, for borderline resectable pancreatic cancer while larger trials define the regimen.
ESPAC5 supports neoadjuvant chemotherapy over immediate surgery in borderline resectable disease and points to FOLFIRINOX as the regimen to build on.
Neoadjuvant modified FOLFIRINOX without routine radiotherapy became the reference approach for borderline resectable disease in North America; radiotherapy is reserved for selected patients or trials.
Neoadjuvant treatment is now the standard for borderline resectable pancreatic cancer, and PREOPANC is the trial guidelines cite; the follow-on PREOPANC-2 tested FOLFIRINOX in the same setting.
The trial that made neoadjuvant treatment standard for borderline resectable disease and opened the still unresolved question for resectable disease, which PREOPANC-2, NORPACT-1, PREOPANC-3 and Alliance A021806 inherited.
Exosome DNA adds signal where free DNA is scarce, particularly after neoadjuvant treatment, and the two together give the strongest published blood-based prognosis in this disease.
FOLFIRINOX and, soon after, gemcitabine plus nab-paclitaxel ended the era of single-agent gemcitabine for metastatic pancreatic cancer. The regimen's modified form later improved survival after surgery in PRODIGE 24, and its toxicity is why fitness, not just stage, decides which treatment a patient is offered.
Query for this cancer: (TITLE:"Borderline resectable pancreatic ductal adenocarcinoma" OR ABSTRACT:"Borderline resectable pancreatic ductal adenocarcinoma" OR TITLE:"Borderline resectable pancreatic cancer" OR ABSTRACT:"Borderline resectable pancreatic cancer" OR TITLE:"BRPC" OR ABSTRACT:"BRPC" OR TITLE:"Marginally resectable pancreatic cancer" OR ABSTRACT:"Marginally resectable pancreatic cancer") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Borderline resectable pancreatic ductal adenocarcinoma, not a curated reading list.