Preoperative Therapy vs. Immediate Surgery for Locally Advanced Pancreatic Cancer

Adjuvant chemotherapy improves survival after surgery for pancreatic cancer, and postoperative FOLFIRINOX is the standard of care. However, there is increasing interest in delivering chemotherapy with or without radiation therapy before surgery in this setting to improve rates of resection and survival.

Investigators now report results of an investigator-initiated, multicenter, open-label, randomized, phase III trial (PREOPANC) involving 246 patients with locally advanced pancreatic cancer who received either preoperative gemcitabine chemotherapy and radiotherapy (followed by surgery and adjuvant gemcitabine) or immediate surgery (followed by adjuvant gemcitabine). Most patients were male (54%–58%) with a median age of 66–67. Most tumors wer…