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The Multidisciplinary Approach to Localized Pancreatic Adenocarcinoma

  • Upper Gastrointestinal Cancers (L Rajdev, Section Editor)
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

Pancreatic adenocarcinoma 2030 (PCa) is predicted to be the second leading cause of cancer death in USA by 2030. To date, attempts at early detection have been unsuccessful. Therapies for resectable PCa include surgery followed by adjuvant chemotherapy with or without radiotherapy. Unfortunately, most patients with PCa present with advanced disease and thus only 20% of patients are potentially resectable upon presentation. Improved surgical techniques along with adjuvant combination chemotherapy have improved outcomes for patients with resectable disease. The optimal treatment approach for borderline resectable and locally advanced unresectable PCa has not yet been defined. Despite significant advances in the palliative treatment of PCa, long-term survival of early stage disease continues to be sobering. The key to improving outcomes for this largely fatal disease is to identify multidisciplinary therapeutic interventions including surgical, medical, and radiation techniques tailored to the patient and their disease characteristics. The neoadjuvant approach provides an in vivo platform to test novel treatment options to help us understand tumor biology and surrounding microenvironment, which may ultimately help us achieve the goal of improvement in long-term survival. While the neoadjuvant approach remains popular as a way to optimally select patients that might benefit most from surgery, randomized trials utilizing adjuvant and neoadjuvant novel therapies hold the key to truly personalizing the ideal treatment strategy for localized PCa.

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Authors and Affiliations

  1. University of Florida, 1600 SW Archer Road, PO BOX 100278, Gainesville, FL, 32608, USA

    Hiral D. Parekh MD, MPH, Jason Starr DO & Thomas J. George Jr. MD, FACP

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  1. Hiral D. Parekh MD, MPH
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  2. Jason Starr DO
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  3. Thomas J. George Jr. MD, FACP
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Correspondence to Thomas J. George Jr. MD, FACP.

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Conflict of Interest

Hiral D. Parekh declares that she has no conflict of interest.

Thomas J. George, Jr. has received institutional research support through grants from Incyte, Bristol-Myers Squibb, Merck, Lilly, Bayer, and AstraZeneca/MedImmune and has received compensation from Merck and Bayer for service as a consultant.

Jason Starr has received compensation from Celgene for service on an advisory board.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Upper Gastrointestinal Cancers

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Parekh, H.D., Starr, J. & George, T.J. The Multidisciplinary Approach to Localized Pancreatic Adenocarcinoma. Curr. Treat. Options in Oncol. 18, 73 (2017). https://doi.org/10.1007/s11864-017-0515-8

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