title: Neoadjuvant therapy in pancreatic cancer: an emerging strategy.
abstract: Pancreatic adenocarcinoma (PDAC) is the fourth leading cause of cancer deaths among men and women, being responsible for 6% of all cancer-related deaths. Surgical resection offers the only chance of cure, but only 15 to 20 percent of cases are potentially resectable at presentation. In recent years, increasing evidences support the use of neoadjuvant strategies in pancreatic cancer in patients with resectable pancreatic cancer as well as in patients with borderline resectable or locally advanced PDAC in order to allow early treatment of micrometastatic disease, tumour regression, and reduced risk of peritoneal tumour implantation during surgery. Furthermore, neoadjuvant treatment allows evaluation of tumour response and increases patient's compliance. However, most evidences in this setting come from retrospective analysis or small case series and in many studies chemotherapy or chemoradiation therapies used were suboptimal. Currently, prospective randomized trials using the most active chemotherapy regimens available are trying to define the real benefit of neoadjuvant strategies compared to conventional adjuvant strategies. In this review, the authors examined available data on neoadjuvant treatment in patients with resectable pancreatic cancer as well as in patients with borderline resectable or locally advanced PDAC and the future directions in this peculiar setting.
authors.affiliation: AOU Ospedali Riuniti, Polytechnic University of the Marche Region, Via Conca 71, 60126 Ancona, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bittoni
authors.affiliation: AOU Ospedali Riuniti, Polytechnic University of the Marche Region, Via Conca 71, 60126 Ancona, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Santoni
authors.affiliation: AOU Ospedali Riuniti, Polytechnic University of the Marche Region, Via Conca 71, 60126 Ancona, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lanese
authors.affiliation: AOU Ospedali Riuniti, Polytechnic University of the Marche Region, Via Conca 71, 60126 Ancona, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Pellei
authors.affiliation: AOU Ospedali Riuniti, Polytechnic University of the Marche Region, Via Conca 71, 60126 Ancona, Italy.
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Andrikou
authors.affiliation: AOU Ospedali Riuniti, Polytechnic University of the Marche Region, Via Conca 71, 60126 Ancona, Italy.
authors.forename: Cascinu
authors.initials: C
authors.lastname: Stefano
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