Skip to main content

Adjuvant treatments for resectable pancreatic cancer

Journal of Hepato-Biliary-Pancreatic Surgery volume 15, pages 468–472 (2008)Cite this article

Abstract

Pancreatic cancer remains one of the most challenging malignancies to treat successfully. The majority of patients present with unresectable advanced-stage cancer, and only 20% of patients can undergo resection. Even if surgical resection is performed, the recurrence rate is high and the survival rate after surgery is poor. Therefore, effective adjuvant therapy is needed to improve the prognosis of patients with pancreatic cancer. Until now, no universally accepted standard adjuvant therapy for this disease has been available: chemoradiotherapy followed by chemotherapy is considered the optimal therapy in the United States, while chemotherapy alone is the current standard in Europe. However, recent randomized controlled trials (RTOG [Radiation Therapy Oncology Group] 9704; CONKO [Charité Onkologie]-001; and a Japanese study) have suggested a benefit of adjuvant chemotherapy with gemcitabine for patients with resectable pancreatic cancer. This article will review the clinical trials of adjuvant therapy for this disease, including the results of recent trials.

This is a preview of subscription content, access via your institution.

References

  1. Kalser MH, Ellenberg SS. Pancreatic cancer. Adjuvant combined radiation and chemotherapy following curative resection. Arch Surg 1985;120:899–903.

    PubMed  CAS  Google Scholar 

  2. Regine WF, Winter KW, Abrams R, Safran H, Hoffman JP, Konski A, et al. RTOG 9704, a phase III study of adjuvant pre and post chemoradiation (CRT) 5-FU vs gemcitabine for resected pancreatic adenocarcinoma. J Clin Oncol 2006;24:1802 (Suppl 18; abstract 4007).

    Google Scholar 

  3. Klinkenbijl JH, Jeekel J, Sahmoud T, van Pel R, Couvreur ML, Veenhof CH, et al. Adjuvant radiotherapy and 5-fluorouracil after curative resection of cancer of the pancreas and periampullary region: phase III trial of the EORTC Gastrointestinal Tract Cancer Cooperative Group. Ann Surg 1999;230:776–782.

    PubMed  Article  CAS  Google Scholar 

  4. Neoptolemos JP, Stocken DD, Friess H, Bassi C, Dunn JA, Hickey H, et al. A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer. N Engl J Med 2004;350:1200–1210.

    PubMed  Article  CAS  Google Scholar 

  5. Blackstock AW, Mornex F, Partensky C, Descos L, Case LD, Melin SA, et al. Adjuvant gemcitabine and concurrent radiation for patients with resected pancreatic cancer: a phase II study. Br J Cancer 2006;95:260–265.

    PubMed  Article  CAS  Google Scholar 

  6. Picozzi VJ, Kozarek RA, Traverso LW. Interferon-based adjuvant chemoradiation therapy after pancreaticoduodenectomy for pancreatic adenocarcinoma. Am J Surg 2003;185:476–480.

    PubMed  Article  Google Scholar 

  7. Knaebel HP, Märten A, Schmidt J, Hoffmann K, Seiler C, Lindel K, et al. Phase III trial of postoperative cisplatin, interferon alpha-2b, and 5-FU combined with external radiation treatment versus 5-FU alone for patients with resected pancreatic adenocarcinoma — CapRI: study protocol. BMC Cancer 2005;5:37.

    PubMed  Article  CAS  Google Scholar 

  8. Bakkevold KE, Arnesjø B, Dahl O, Kambestad B. Adjuvant combination chemotherapy (AMF) following radical resection of carcinoma of the pancreas and papilla of Vater — results of a controlled, prospective, randomised multicentre study. Eur J Cancer 1993;29A:698–703.

    PubMed  Article  CAS  Google Scholar 

  9. Takada T, Amano H, Yasuda H, Nimura Y, Matsushiro T, Kato H, et al. Study Group of Surgical Adjuvant Therapy for Carcinomas of the Pancreas and Biliary Tract. Is postoperative adjuvant chemotherapy useful for gallbladder carcinoma? A phase III multicenter prospective randomized controlled trial in patients with resected pancreaticobiliary carcinoma. Cancer 2002;95:1685–1695.

    PubMed  Article  Google Scholar 

  10. Kosuge T, Kiuchi T, Mukai K, Kakizoe T; Japanese Study Group of Adjuvant Therapy for Pancreatic Cancer (JSAP). A multicenter randomized controlled trial to evaluate the effect of adjuvant cisplatin and 5-fluorouracil therapy after curative resection in cases of pancreatic cancer. Jpn J Clin Oncol 2006;36:159–165.

    PubMed  Article  Google Scholar 

  11. Stocken DD, Büchler MW, Dervenis C, Bassi C, Jeekel H, Klinkenbijl JHG, et al. Meta-analysis of randomised adjuvant therapy trials for pancreatic cancer. Br J Cancer 2005;92:1372–1381.

    PubMed  Article  CAS  Google Scholar 

  12. Oettle H, Post S, Neuhaus P, Gellert K, Langrehr J, Ridwelski K, et al. Adjuvant chemotherapy with gemcitabine vs observation in patients undergoing curative-intent resection of pancreatic cancer: a randomized controlled trial. JAMA 2007;297:267–277.

    PubMed  Article  CAS  Google Scholar 

  13. Kosuge T, Ueno H, Matsuyama Y, Yamamoto J, Nakao A, Egawa S, et al. A randomized phase III study comparing gemcitabine monotherapy with observation in patients with resected pancreatic cancer. Eur J Cancer 2007 (ECCO14 Abstract Book; abstract 3504).

  14. Okusaka T, Funakoshi A, Furuse J, Boku N, Yamao K, Ohkawa S, et al. A late phase II study of S-1 for metastatic pancreatic cancer. Cancer Chemother Pharmacol 2008;61:615–621.

    PubMed  Article  CAS  Google Scholar 

Download references

Author information

Affiliations

  1. Hepatobiliary and Pancreatic Oncology Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Hideki Ueno

  2. Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, Tokyo, Japan

    Tomoo Kosuge

Authors
  1. Hideki Ueno
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tomoo Kosuge
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Ueno, H., Kosuge, T. Adjuvant treatments for resectable pancreatic cancer. J Hepatobiliary Pancreat Surg 15, 468–472 (2008). https://doi.org/10.1007/s00534-008-1357-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00534-008-1357-3

Key words

  • Pancreatic cancer
  • Adjuvant therapy
  • Chemoradiotherapy
  • Chemotherapy