Articles related to NEOADJUVANT TREATMENT

Neoadjuvant Chemotherapy and Upfront Surgery: A Comparative Study in Resectable Pancreatic Cancer In a recent study presented at the 2023 ASCO Annual Meeting, researchers found no significant survival benefit of neoadjuvant chemotherapy over upfront surgery in patients with resectable pancreatic cancer. Key Points: “Results of this trial do not support neoadjuvant FOLFIRINOX as standard of care in resectable pancreatic cancer.” Knut Jørgen Labori, MD, PhD, Oslo University Hospital, Norway

In a recent study presented at the American Association for Thoracic Surgery (AATS) Annual Meeting, researchers reported that more than 75% of patients who received neoadjuvant chemotherapy combined with an immune checkpoint inhibitor (ICI) were still alive and event-free at 1 year. The treatment was also well-tolerated, with a manageable rate of side effects. The 1-year event-free survival rate was 78.3%, and the 1-year overall survival rate was 88.0%. The postoperative complication rate was 35.6%, and the rate of grade 3 or higher treatment-related adverse events was 18.1%. The most common side effects were leukopenia, neutropenia, thrombocytopenia, anemia, and hyperglycemia. Overall, the results of this study suggest that neoadjuvant chemotherapy combined with an ICI is a safe and effective treatment option for patients with resectable esophageal cancer. The treatment was associated with a high rate of pCR and R0 resection, and the side effects were generally manageable.

In this multi-institutional study, AT significantly increased progression-free and overall survival in 430 patients with node-negative (N0) disease after NAT for localized pancreatic cancer (4.1 vs 2.1 and 5.3 vs 3.5 years, respectively). Patients who received neoadjuvant radiation had their overall survival benefit scaled back, while patients with perineural invasion saw an increase.

The meta-analysis included data from nearly 13,000 patients across 30 published trials. Grade 3 or 4 AEs occurred in nearly 70% of patents receiving TKIs compared with 37% for those receiving ICIs.

The 18-month OS rates in this trial were: 66.7% for neoadjuvant mFOLFIRINOX 47.3% for neoadjuvant mFOLFIRINOX and hypofractionated radiotherapy 87.5% for mFOLFIRINOX followed by pancreatectomy 78.9% for mFOLFIRINOX plus radiotherapy followed by pancreatectomy The authors state these results “suggest that mFOLFIRINOX represents a reference neoadjuvant treatment regimen for borderline resectable pancreatic cancer; however, the role of radiotherapy in this setting remains undefined.”

The study was comprised of 17,913 men with a median age of 64 years with pT2-4N1M0 prostate cancer (PC) consecutively treated between 1995 and 2017, with postradical prostatectomy (RP) and pelvic lymph node (LN) assessment. The patients were then followed for possible treatment with adjuvant radiation therapy (aRT) or early salvage radiation therapy (sRT). It was determined that men with pN1 PC and 4 or more as compared with 1-3 positive pelvic LNs appear to benefit the most from the use of aRT.