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

FOLFOX vs. Chemoradiotherapy: A Comparative Study in Locally Advanced Rectal Cancer Treatment A recent study has shed light on the efficacy of neoadjuvant FOLFOX (fluorouracil, leucovorin, and oxaliplatin) as an alternative to chemoradiotherapy in treating locally advanced rectal cancer. The findings suggest a potential shift in the standard care approach. “In patients with locally advanced rectal cancer who were eligible for sphincter-sparing surgery, preoperative FOLFOX was noninferior to preoperative chemoradiotherapy with respect to disease-free survival.” PROSPECT ClinicalTrials.gov number, NCT01515787

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.

Event-free survival was significantly longer in patients with resectable stage III or IV melanoma who received pembrolizumab both before and after surgery than in those who received adjuvant pembrolizumab alone. New toxic effects were not discovered.

An earlier analysis of this phase 3 trial of neoadjuvant and adjuvant therapy showed that the addition of pembrolizumab to neoadjuvant chemotherapy resulted in a significantly higher percentage of patients with early triple-negative breast cancer having a pathological complete response (defined as no invasive cancer in the breast and negative nodes) at definitive surgery. The trial’s main findings on event-free survival have not been published.

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.