Multimodal treatment of resectable pancreatic ductal adenocarcinoma

Francesco Cellini, Vincenzo Valentini, Alessio Giuseppe Morganti, Vito Lorusso, Nicola Silvestris, Oronzo Brunetti, Enrico Vasile, Ivana Cataldo, Valeria Pusceddu, Monica Cattaneo, Stefano Partelli, Mario Scartozzi, Giuseppe Aprile, Andrea Casadei Gardini, Aldo Scarpa, Massimo Falconi, Angela Calabrese, Michele Reni, Stefano Cascinu

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

After a timing preoperative staging, treatment of resectable pancreatic adenocarcinoma (PDAC) includes surgery and adjuvant therapies, the former representing the initial therapeutic option and the latter aiming to reduce the incidence of both distant metastases (chemotherapy) and locoregional failures (chemoradiotherapy). Herein, we provide a critical overview on the role of multimodal treatment in PDAC and on new opportunities related to current more active poli-chemotherapy regimens, targeted therapies, and the more recent immunotherapy approaches. Moreover, an analysis of pathological markers and clinical features able to help clinicians in the selection of the best therapeutic strategy will be discussed. Lastly, the role of neoadjuvant treatment of initially resectable disease will be considered mostly in patients whose malignancy shows morphological but not clinical or biological criteria of resectability. Depending on the results of these investigational studies, today a multidisciplinary approach can offer the best address therapy for these patients.
Original languageEnglish
Pages (from-to)152-165
Number of pages14
JournalCRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY
Volume111
DOIs
Publication statusPublished - 2017

Keywords

  • Adjuvant
  • Carcinoma, Pancreatic Ductal
  • Chemoradiotherapy
  • Chemotherapy
  • Chemotherapy, Adjuvant
  • Combined Modality Therapy
  • Geriatrics and Gerontology
  • Hematology
  • Humans
  • Immunotherapy
  • Neoadjuvant Therapy
  • Oncology
  • Pancreatic Neoplasms
  • Pancreatic ductal adenocarcinoma
  • Radiotherapy
  • Randomized Controlled Trials as Topic
  • Target therapy

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