What are the NCCN guidelines for neoadjuvant therapy for pancreatic cancer?

Updated: Jan 10, 2020
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

The NCCN finds there is limited evidence to recommend specific neoadjuvant regimens off-study for patients with resectable or borderline resectable tumor, and practices vary with regard to the use of chemotherapy and radiation. The guidelines prefer consultation at a high-volume center when considering neoadjuvant therapy. If recommended, treatment should be at or coordinated through a high-volume center when possible.  Participation in a clinical trial is encouraged. [2]

Possible regimens include the following [2] :

  • FOLFIRINOX/modified FOLFIRINOX, with or without subsequent chemoradiation
  • Gemcitabine + albumin-bound paclitaxel, with or without subsequent chemoradiation
  • Gemcitabine + cisplatin (≥2–6 cycles) followed by chemoradiation (only for known  BRCA1/2 mutations)

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