Matthew H.G. Katz, MD, FACS, discusses the eligibility criteria for up-front surgery in patients with pancreatic cancer.
Matthew H.G. Katz, MD, FACS, associate professor, Department of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, discusses the eligibility criteria for up-front surgery in patients with pancreatic cancer.
There has never been a study that randomized patients with optimal characteristics to receive either neoadjuvant or adjuvant therapy, says Katz. Currently, however, a study through the Alliance for Clinical Trials in Oncology is in development and will randomize patients to treatment arms of postoperative FOLFIRINOX versus perioperative FOLFIRINOX.
There is a role for neoadjuvant systemic therapy, even for patients who otherwise appear to be eligible for surgery. In those situations, patients have the option of receiving surgery up front. For patients to receive up-front surgery, they must have a resectable tumor, a normal CA19-9 level, and be overall healthy; however, patients with pancreatic cancer do not often meet all 3 of those criteria, concludes Katz.