Zensai.

By this point, most people are treating borderline resectable pancreatic cancer with some version of upfront neoadjuvant radiation and chemo. In this Japanese phase 2 trial, 45 patients received the strategy of conventionally-fractionated radiation (1.8 Gy x 28 = 50.4 Gy) with concurrent S-1 (i.e., the Asian version of oral capecitabine) followed by gemcitabine x 3 cycles. Similar to the Dutch PREOPANC-1 trial (2.4 Gy x 15 = 36 Gy with concurrent and sequential gem), nearly two-thirds of enrollees (n=28) moved forward with resection. And, again, nearly all of those (n=27) achieved negative margins. Another striking similarity was the median survival among those completing all planned therapy, which was 32 months here versus 30 months in PREOPANC-1. TBL: Here’s more data, with a slightly different spin, confirming excellent outcomes among the roughly two-thirds of patients with borderline resectable pancreatic cancer who receive neoadjuvant chemoradiation and move forward with oncologic resection. | Hayashi, Int J Radiat Oncol Biol Phy 2019