Opinion Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 28, 2020; 26(4): 375-382
Published online Jan 28, 2020. doi: 10.3748/wjg.v26.i4.375
Neoadjuvant therapy for resectable pancreatic ductal adenocarcinoma: The need for patient-centered research
Jordan M Cloyd, Allan Tsung, John Hays, Celia E Wills, John FP Bridges
Jordan M Cloyd, Allan Tsung, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
John Hays, Department of Internal Medicine, The Ohio State University, Columbus, OH 43210, United States
Celia E Wills, College of Nursing, The Ohio State University, Columbus, OH 43210, United States
John FP Bridges, Department of Biomedical Informatics, The Ohio State University, Columbus, OH 43210, United States
Author contributions: Cloyd JM conceived the idea for the manuscript. Cloyd JM, Tsung A, Hays J, Wills CE, and Bridges JFP reviewed the literature and drafted the manuscript.
Conflict-of-interest statement: There are no financial disclosures, and submission of this manuscript has been approved by all authors.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jordan M Cloyd, MD, Assistant Professor, Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center, 410 W 10th Ave, N-907 Doan Hall, Columbus, OH 43210, United States. jordan.cloyd@osumc.edu
Received: October 11, 2019
Peer-review started: Otober 11, 2019
First decision: December 5, 2019
Revised: January 2, 2020
Accepted: January 11, 2020
Article in press: January 11, 2020
Published online: January 28, 2020
Abstract

Pancreatic ductal adenocarcinoma is an aggressive cancer with high recurrence rates following surgical resection. While adjuvant chemotherapy improves survival, a significant proportion of patients are unable to initiate or complete all intended therapy following pancreatectomy due to postoperative complications or poor performance status. The administration of chemotherapy prior to surgical resection is an alternative strategy that ensures its early and near universal delivery as well as improves margin-negative resection rates and potentially improves long-term survival outcomes. Neoadjuvant therapy is increasingly being recommended to patients with pancreatic ductal adenocarcinoma, however, patient-centered research on its use is lacking. In this review, we highlight opportunities to focus research efforts in the domains of patient preferences, patient-reported outcomes, patient experience, and survivorship. Novel research in these areas may identify relevant barriers and facilitators to the use of neoadjuvant therapy thereby increasing its utilization, improve shared-decision making for patients and providers, and optimize the experience of those undergoing neoadjuvant therapy.

Keywords: Preoperative therapy, Pancreatic ductal adenocarcinoma, Quality of life, Shared decision making, Patient preferences

Core tip: Neoadjuvant therapy is increasingly being recommended to patients with pancreatic ductal adenocarcinoma, however, patient-centered research on its use is lacking. In this review, we highlight opportunities to focus research efforts in the domains of patient preferences, patient-reported outcomes, patient experience, and survivorship. Novel research in these areas may identify relevant barriers and facilitators to the use of neoadjuvant therapy thereby increasing its utilization, improving shared-decision making for patients and providers, and optimizing the experience of those undergoing neoadjuvant therapy.