Published online Jun 21, 2019. doi: 10.3748/wjg.v25.i23.2839
Peer-review started: March 7, 2019
First decision: April 5, 2019
Revised: April 17, 2019
Accepted: April 29, 2019
Article in press: April 29, 2019
Published online: June 21, 2019
Core tip: Adjuvant chemotherapy for pancreatic cancer has been developed based on the experiences made with palliative chemotherapy. Nevertheless, the optimal regimen remains controversial. The Partenariat de Recherche en Oncologie Digestive 24 trial showed an impressive benefit of modified FOLFIRINOX over gemcitabine alone. The remarkable results mark a new milestone in treating resectable pancreatic cancer and have now changed the standard of care. Here, we discuss an issue of difference between this trial and previous phase III trials, as well as potential biomarkers predicting therapeutic response. Several ongoing trials of replacing part of the FOLFIRINOX regimen with other drugs for pancreatic cancer are also summarized.