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Adjuvant chemotherapy with either 5-FU/leucovorin or gemcitabine, with or without postoperative radiotherapy, modestly improves survival compared with surgery alone in patients with resected pancreatic cancer. Despite advances in the systemic treatment of metastatic disease, little progress has been made in the postsurgical treatment of this disease.
Investigators from Japan now report the results of an industry-sponsored, multicenter, randomized, open-label, noninferiority phase III trial (JASPAC 01) comparing adjuvant weekly gemcitabine to oral S-1 in 378 patients with resected pancreatic cancer. Most patients had R0 resection (86%–88%), T3 disease (88%), and node-positive disease (62%–64%); a minority (23%–19%) had CA 19-9 elevation prior…