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International Session (Symposium)2 (JSGE・JGES・JSGS)
Thu. October 12th   14:00 - 17:00   Room 11: Fukuoka International Congress Center 502+503
Neoadjuvant chemotherapy for pancreatic cancer planned resection
F. Motoi1, M. Unno1
1Department of Surgery, Tohoku University
The majority of patients with presumed localized pancreatic cancer (PC) have clinically occult metastases at the time of diagnosis. Although surgery is the best treatment for local clearance, the outcome remains poor even for resectable disease. Recent advance of post-operative adjuvant chemotherapy has improved the survival for resected and recovered PC, however, approximately half of the patients with PC planned resection could not receive the best practice. Neoadjuvant chemotherapy (NAC) is promising alternative for resectable PC to maximize the population receiving best practice.
PC patients with Resectable or borderline resectable (BR-PV) planned upfront-surgery or NAC with gemcitabine and S1 (NAC-GS) were reviewed by Intention-to-Treat analysis (ITT). From 2001 to 2016, 336 eligible patients were treated by Upfront-surgery or NAC-GS in our institution. NAC-GS prolonged the survival, compared to Upfront-surgery significantly (p=0.027) by ITT. BR-PV treated by NAC-GS showed a significant longer survival (p=0.0043) than upfront-surgery. NAC-GS improved the surrogate endpoints, which were significant increase the population of normal tumor marker value after resection (p=0.0007) in total cohort, also increase the resection rate (p=0.17) and R0-resection rate (p=0.16) in BR-PV subgroup.
PREP-02/JSAP05 (UMIN000009634) is a prospective randomized phase-II/III trial to evaluate superiority in survival of NAC-GS against Upfront-surgery in patients with resectable PC. The enrollment was finished with 364 patients from 47 centers in Japan on January 2016. PREP-02 study will determine the efficacy of NAC-GS in addition to standard post-operative adjuvant for resectable PC.
Index Term 1: Neoadjuvant chemotherapy
Index Term 2: Pancreatic cancer
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