Home Health & Wellness Advanced Therapy Raises Survival in Specific Pancreatic Cancers, Study Finds

Advanced Therapy Raises Survival in Specific Pancreatic Cancers, Study Finds

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A recent study highlights a groundbreaking approach in the treatment of borderline resectable pancreatic cancer (BRPC) and locally advanced pancreatic cancer (LAPC), offering hope for increased survival rates.

Pancreatic cancer, a notoriously aggressive malignancy, often presents a challenge due to its late detection and difficulty in treatment. Historically, survival rates for pancreatic cancer have been low. However, the latest research indicates a shift towards more effective treatment strategies. The cornerstone of treatment for localised pancreatic cancer is surgical resection combined with systemic chemotherapy. Unfortunately, in cases with extensive vascular involvement – classified as BRPC or LAPC – upfront surgery is not optimal.

The use of preoperative multi-agent chemotherapy, such as FOLFIRINOX or gemcitabine plus nab-paclitaxel, followed by radiotherapy has shown promising results. This preoperative approach, designed to achieve both local and systemic control, is increasingly being used to select suitable candidates for surgery. National and international guidelines, however, vary significantly in their recommendations regarding the type, duration, and combination of preoperative treatments. Despite these variations, recent randomised controlled trials have consistently reported improved outcomes with neoadjuvant chemotherapy or chemoradiotherapy compared to upfront surgery.

The findings were published in the journal Nature Review Gastroenterology & Hepatology

A major challenge in this treatment approach is the evaluation of tumour response to preoperative therapy. Conventional cross-sectional imaging often underestimates the tumour response, necessitating reliance on biological response evaluation, particularly a decrease in serum CA19-9. But the need for more accurate tumour markers is urgent.

The decision to proceed with surgery following preoperative therapy requires careful consideration of various factors. High-volume expertise is needed for patient selection, intraoperative decision-making, extended resections, and postoperative care. Importantly, preoperative counselling and shared decision-making play a critical role in this process.

The study outlines a future research agenda focusing on clinical trials that assess the efficacy of modern multi-agent chemotherapy and radiotherapy. The importance of standardised assessment methods for tumour regression grading and patient condition evaluation is also highlighted.

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