Dr. Wainberg on the Potential Role of Neoadjuvant Chemotherapy in Pancreatic Cancer

Zev A. Wainberg, MD, associate professor of medicine and surgery, David Geffen School of Medicine, University of California, Los Angeles (UCLA), co-director, UCLA Gastrointestinal Oncology Program, director, Early Phase Clinical Research Program, Jonsson Comprehensive Cancer Center, discusses the potential role of neoadjuvant chemotherapy in pancreatic cancer.

Currently, the role of neoadjuvant chemotherapy in patients with resectable pancreatic cancer is not clear, says Wainberg. Historically, all patients with resectable disease were taken immediately to surgery and not given neoadjuvant therapy, Wainberg explains.

However, findings from the phase 2/3 Prep-02/JSAP-05 trial demonstrated a significant survival advantage with neoadjuvant chemotherapy. Specifically, with gemcitabine plus tegafur/gimeracil/oteracil (S-1) vs up-front surgery in patients with resectable pancreatic cancer. These findings are not necessarily translatable because the study utilized a chemotherapy regimen that is not standard in the United States and all patients were Japanese, Wainberg says. However, the study does offer proof of principle that neoadjuvant therapy could be considered in some patients with resectable disease and that further research is warranted, concludes Wainberg.