Dr. Hidalgo Medina on Neoadjuvant Therapy in Pancreatic Cancer

Manuel Hidalgo Medina, MD, PhD, chief, Division of Hematology and Medical Oncology, Weill Cornell Medicine/NewYork-Presbyterian Hospital, discusses the emergence of neoadjuvant chemotherapy and radiation in pancreatic cancer.

Traditionally, treatment for resectable pancreatic cancer involved surgery followed by adjuvant chemotherapy and, to some extent, that is still considered the standard of care; however, the field is moving towards neoadjuvant therapy, explains Hidalgo Medina. With patients who have disease that is a little larger than what is considered resectable, neoadjuvant chemotherapy and potentially radiation are used to achieve tumor shrinkage prior to surgery.

Neoadjuvant therapy is also likely beneficial in patients with resectable small disease and is the only option for patients with locally advanced disease that is not resectable. As chemotherapy becomes more effective and radiation becomes technically better, the pancreatic cancer field is going to move towards neoadjuvant chemotherapy; however, large, randomized clinical trials are still required, concludes Hidalgo Medina.