Table 2.
Recently published prospective neoadjuvant trials of multimodal therapy for pancreatic cancer n (%)
| Ref. | Initial staging |
Regimen |
Resection | Survival | Notes | |
| Chemoradiation | Chemotherapy | |||||
| Palmer et al[106], 2007 | Resectable (n = 50) | N/A | Gem vs Gem + Cis | Overall: 27 (54); Gem: 9 (38), Gem + Cis: and 18 (70) | Gem: 42%, Gem + Cis: 62% (1 yr survival) | Randomized Phase II; No difference in surgical complcations |
| Le Scodan et al[41], 2008 | Resectable (n = 41) | 50 Gy + 5-FU + Cis | N/A | 26 (63) | Overall: 9.4 mo, R: 11.7 mo (2 yr survival 32%) UR: 5.7 mo | Phase II; 67.5% were successfully treated with entire radiation dose and ≥ 75% chemotherapy dose; 81% achieved an R0 resection |
| Heinrich et al[107], 2008 | Resectable (n = 28) | N/A | Gem + Cis | 26 (93) | Overall: 26.5 mo; R: 19.1 mo | Phase II; 80% achieved an R0 resection |
| Evans et al[19], 2008 | Resectable (n = 86) | 30 Gy + Gem | N/A | 64 (74) | Overall: 22.7 mo; R: 34 mo, UR: 7 mo (P < 0.001) | Phase II; 27% 5 yr OS, 36% vs 0% for resected vs unresected |
| Varadhachary et al[33], 2008 | Resectable (n = 90) | 30 Gy + Gem + Cis | Gem + Cis | 52 (66) | Overall: 17.4 mo; R: 31 mo, UR: 10.5 mo | Phase II |
| Turrini et al[108], 2010 | Resectable (n = 34) | 45 Gy + Docetaxel | N/A | 17 (50) | R: 32 mo | Phase II; 10% R0 resection; 5 yr survival resected 41% |
| Landry et al[109], 2010 | Borderline | Arm A: 50.4 Gy + Gem (n = 10) | Arm B: Gem + Cis + 5-FU then 50.4 Gy + 5-FU (n = 11) | A: 3 (30) B: 2 (22) | R: 26.3 mo A: 19.4 mo B: 13.4 mo | Phase II; early termination due to poor accrual |
| Sahora et al[45], 2011 | Unresectable (n = 18), borderline (n = 15) | N/A | Gem + Oxaliplatin | 13 (39) | R: 22 mo UR: 12 mo (P = 0.046) | Phase II; 69% R0 resection |
| Sahora et al[46], 2011 | Borderline (n = 12), Unresectable (n = 13) | N/A | Gem + Docetaxel | 8 (32) | R: 16 mo, UR: 12 mo | Phase II; 87% R0 resection |
| Pipas et al[43], 2012 | Resectable (n = 4), Borderline (n = 23), Unresectable (n = 6) | 54 Gy + Cetuximab + Gem | N/A | 25 (76) | R: 24.3 mo | Phase II; 92% R0 resection |
| Wo et al[51], 2013 | Resectable (n = 10) | Short-course photon RT (3 Gy × 10, 5 Gy × 5 qod, 5 Gy × 5 qd) + Capecitabine | N/A | N/A | N/A | Phase I; closed early due to intraoperative complications (fibrosis) |
| Kim et al[44], 2013 | Resectable (n = 23), Borderline (n = 39), Unresectable (n = 6) | 30 Gy + Gem + Oxaliplatin | N/A | 43 (63) | Overall: 18.2 mo; R:27.1 mo, UR: 10.9 | Phase II, multi-institutional |
| Shinoto et al[52], 2013 | Resectable (n = 26) | 30.0-36.8 Gy E of Carbon-ion radiotherapy (CIRT) | N/A | 21 (81) | Overall: 42%, R: 52% (5 yr survival) | Phase I; short course radiation |
Gem: Gemcitabine, Cis: Cisplatin; 5-FU: Fluorouracil; Gy: Gray; R: Resected patients; UR: Unresected patients; N/A: Not available.