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Adjuvant Therapy for Pancreatic Cancer

Survival for patients with pancreas cancer is correlated to stage. Only 20% of patients present with localized diseaseamenable to potentially curative resection but, despite resection, the 5-year survival rate for early stage patients remainsless than 25%. Current accepted standard of care is adjuvant gemcitabine following curative resection but there have beenno conclusions regarding the role or timing of adjuvant chemoradiation. Although systemic disease represents the major riskfor failure following resection, there are patients who would benefit from adjuvant local therapy that remain difficult toidentify at present. This year at 2014 ASCO Gastrointestinal Cancers Symposium, Cho at al. (Abstract #325) presented theresults of adjuvant gemcitabine with the addition of docetaxel followed by 5-FU chemoradiation for patients with resectedpancreatic cancer. Kumar et al. (Abstract #330) compared adjuvant chemoradiation to adjuvant chemotherapy. LastlyHeestand et al. (Abstract #176) used a novel way to look at different biomarkers in serum of patients in the RTOG 9407 studyand evaluated the survival depending on the type of chemotherapy used. A lower serum CEA and CA 19-9 gave a betteroverall survival in all patients which has already been established. Low levels of matrix metalloproteinase-7 (MMP-7)predicted an overall survival benefit from adjuvant gemcitabine, but not from 5-FU.


Martin D Goodman

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