Dr. Katz on Preoperative Chemotherapy in Resectable 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 utility of preoperative chemotherapy for patients with resectable pancreatic cancer.

Surgical resection followed by 6 months of systemic chemotherapy has been the mainstay of treatment for patients with resectable pancreatic cancer for many years, says Katz. Currently, the standard of care for these patients is pancreaticoduodenectomy or distal pancreatectomy followed by FOLFIRNOX.

However, current ASCO guidelines recommend the administration of preoperative systemic chemotherapy for patients who have large or anatomically advanced tumors, patients with poor performance status that renders them ineligible for upfront surgery, and patients with occult metastatic disease detected with imaging or elevated CA 19-9 levels, concludes Katz.

While preoperative chemotherapy has not been adopted as the standard of care in this patient population, it can be considered in the right patient, explains Katz. Preoperative radiation therapy may provide additional benefit for these patients, concludes Katz.