Neoadjuvant therapy for pancreas cancer: Global perspective and optimal care pathways in low to middle-income countries

J Surg Oncol. 2021 May;123(6):1441-1448. doi: 10.1002/jso.26365.

Abstract

Surgery remains the only curative intent treatment modality for localized pancreatic adenocarcinoma. Even in those who can undergo successful margin negative resection, the ability to deliver adjuvant chemotherapy is suboptimal for various reasons, resulting in poor outcomes. The delivery of "standard of care" intensive modern neoadjuvant therapies can be challenging in low to-middle-income countries (LMICs) with limited resource. This article reviews the constraints in delivering neoadjuvant therapies in LMICs and strategies to improve its implementation.

Keywords: borderline resectable; global perspective; low to middle income countries; neoadjuvant therapy; pancreatic cancer.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Chemotherapy, Adjuvant
  • Clinical Trials, Phase III as Topic
  • Fluorouracil / administration & dosage
  • Humans
  • Irinotecan / administration & dosage
  • Leucovorin / administration & dosage
  • Neoadjuvant Therapy
  • Oxaliplatin / administration & dosage
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery
  • Pancreatic Neoplasms / therapy*
  • Radiotherapy, Adjuvant
  • Randomized Controlled Trials as Topic
  • Tertiary Care Centers

Substances

  • folfirinox
  • Oxaliplatin
  • Irinotecan
  • Leucovorin
  • Fluorouracil