The neoadjuvant approach in resectable pancreatic ductal adenocarcinoma: lessons learned

Neoadjuvant chemotherapy in resectable pancreatic ductal adenocarcinoma is not currently recommended as standard practice but can be considered for patients at high risk (eg, high CA19-9, systemic symptoms, or nodal disease) or in a clinical trial.1,2 The PRODIGE24/CCTG-PA.6 adjuvant trial demonstrated the longest median overall survival reported to date of 53·5 months (95% CI 43·5–58·4) in a select cohort and documented the importance of completing adjuvant therapy.3 In the real-world setting, up to half of patients do not receive postoperative chemotherapy, and thus a neoadjuvant approach might allow for improved delivery of chemotherapy.