Michael A. Choti, MD, discusses the benefit of neoadjuvant chemotherapy in pancreatic cancer.
Michael A. Choti, MD, chief of surgery, Banner MD Anderson Cancer Center, discusses the benefit of neoadjuvant chemotherapy in pancreatic cancer.
Although the guidelines for pancreatic cancer suggest up-front surgery, data from recent studies are making it clear that neoadjuvant chemotherapy is superior to up-front surgery, particularly with regard to a pancreaticoduodenectomy. Neoadjuvant chemotherapy provides patients with the opportunity to receive the therapy, explains Choti. If the pancreaticoduodenectomy is performed first, these frail patients tend to have a longer recovery and sometimes never receive chemotherapy after surgery, says Choti.
Furthermore, neoadjuvant chemotherapy treats the micrometastatic disease earlier compared with delaying until after surgery. Patients who receive surgery up front may not receive chemotherapy until months after surgery, if at all. For all those reasons, neoadjuvant chemotherapy appear to be the superior up-front approach, concludes Choti.