Cancer

Internal medicine

Surgery

Oncology

Chemotherapy

FOLFIRINOX

Capecitabine

Neoadjuvant therapy

Chemoradiotherapy

Folinic acid

Pancreatic cancer

Gemcitabine

Irinotecan

Fluorouracil

Oxaliplatin

Radiation therapy

Colorectal cancer

Breast cancer

Medicine

The Lancet. Gastroenterology & hepatology

Recruitment was challenging. There was no significant difference in resection rates between patients who underwent immediate surgery and those who underwent neoadjuvant therapy. Short-course (8 week) neoadjuvant therapy had a significant survival benefit compared with immediate surgery. Neoadjuvant chemotherapy with either gemcitabine plus capecitabine or FOLFIRINOX had the best survival compared with immediate surgery. These findings support the use of short-course neoadjuvant chemotherapy in patients with borderline resectable pancreatic ductal adenocarcinoma.

Immediate surgery compared with short-course neoadjuvant gemcitabine plus capecitabine, FOLFIRINOX, or chemoradiotherapy in patients with borderline resectable pancreatic cancer (ESPAC5): a four-arm, multicentre, randomised, phase 2 trial