Adjuvant and neoadjuvant therapy for pancreatic cancer

Pancreatic cancer still remains a major cause of cancer-related mortality; however, there is a slight but continuous improvement in survival over the past 2 decades. Progress in chemotherapy has contributed to the survival improvement in patients with any stage of pancreatic cancer. In this review, we summarize the currently available evidence regarding adjuvant and neoadjuvant therapy with a focus mainly on randomized controlled trial. The median overall survival in resected pancreatic cancer patients has significantly improved to 22.8 to 54.4 months with the use of adjuvant therapy from 11 to 20.2 months with a strategy of observation only. Recent data from randomized trials support the use of neoadjuvant therapy for patients with resectable or borderline resectable pancreatic cancer. But given a variety of neoadjuvant regimens and different definitions of resectability status, data should be interpreted with caution. Several other trials are ongoing and will provide further evidence.