Advances in neoadjuvant therapy for pancreatic cancer: Current trends and future directions

Table 2 Neoadjuvant therapy in borderline resectable pancreatic cancer

Ref.	Type of study	Year	Treated with radiotherapy	Total (n)	Stage of disease	Treatment regimen	Resection rate (%)	R0 resection rate (%)	Median OS (months)	Median DFS (months)
Tran et al[75]	Clinical trial	2020	Yes	25	BRPC	FOLFIRINOX + radiotherapy + gemcitabine	52	100	24.4	NR
Springett et al[76]	Clinical trial	2008	Yes	130	BRPC	Gemcitabine + chemoradiation	Improved resectability	NR	NR	NR
Okada et al[77]	Clinical trial	2016	No	10	BRPC	mFOLFIRINOX	70	71.4	NR	NR
Chaudhari et al[78]	Clinical trial	2022	Yes	70	BRPC	Gemcitabine + radiotherapy + surgery	62.5	80.2	28.4	NR
Katz et al[79]	Clinical trial	2016	Yes	22	BRPC	mFOLFIRINOX + capecitabine + radiotherapy	68.2	93.3	21.7	NR
Murphy et al[80]	Clinical trial	2018	Yes	48	BRPC	FOLFIRINOX + radiotherapy	66.7	96.9	37.3	NR
Peng et al[81]	Clinical trial	2019	No	85	BRPC	Pathologic tumor response to NAT correlated with node-negative disease	NR	NR	No significant OS benefit	NR
Masui et al[82]	Clinical trial	2016	No	18	BRPC	Gemcitabine + S1	83.3	80	21.7	NR
			No	19	BRPC	Upfront surgery	100	52.6	21.1	NR
Heinrich et al[83]	Clinical trial	2019	Yes	100	BRPC	Total neoadjuvant therapy	Improved pathologic response	NR	Improved OS in pCR patients	NR
Javed et al[84]	Retrospective study	2019	Yes	151	BRPC	Fluorouracil-based + radiotherapy	63.6	77.1	23.7	NR
Patel et al[85]	Retrospective study	2011	Yes	14	BRPC	Gemcitabine + docetaxel + capecitabine + 5-FU + radiotherapy	64.3	88.9	15.64	10.48
Kim et al[86]	Retrospective study	2017	Yes	40	BRPC	Gemcitabine-based + radiotherapy	85	76.5	20	NR
Barnes et al[87]	Retrospective study	2019	Yes	185	BRPC	FOLFIRINOX + radiotherapy	62.2	96.5	20	19
Ielpo et al[73]	Retrospective study	2017	Yes	26	BRPC	Gemcitabine and nab-paclitaxel + radiotherapy	61.5	NR	18.9	NR
			No	19	BRPC	Upfront surgery	100	NR	13.5	NR

To provide a clearer understanding of the impact of neoadjuvant therapy (NAT) on borderline resectable pancreatic cancer (BRPC), Table 2 provides a comprehensive summary of clinical trials and retrospective studies evaluating NAT in patients with borderline BRPC. This table highlights key metrics, including treatment regimens, whether radiotherapy was used, resection rates, margin-negative (R0) resection rates, median overall survival, and disease-free survival. The data underscore the critical role of NAT in enhancing surgical outcomes for BRPC patients by increasing resection rates and achieving R0 resections, which are pivotal for long-term survival. Table 2 illustrates the efficacy of different NAT strategies in managing the unique challenges posed by BRPC, offering valuable insights for optimizing treatment protocols and advancing clinical management of this subset of pancreatic cancer. RPC: Resectable pancreatic cancer; BRPC: Borderline resectable pancreatic cancer; NAT: Neoadjuvant therapy; R0: Margin-negative resection; OS: Overall survival; DFS: Disease-free survival; FOLFIRINOX: Fluorouracil, leucovorin, irinotecan, and oxaliplatin; NR: Not reported.