Intensified neoadjuvant chemotherapy with SBRT for a borderline resectable pancreatic cancer: A plea for prospective evaluation

BJMO - volume 15, issue 2, march 2021

L. Mans MD, M. Pezzullo MD, M.A. Bali MD, PhD, L. Verset MD, PhD, J. Closset MD, C. Bouchart MD, J-L. van Laethem MD, PhD


Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer-related death and its 5-year overall survival is poor. Surgery remains the only curative treatment but less than 20% of the patients are resectable at diagnosis. New treatment options for the management of metastatic disease have recently emerged, and with them the question of their use in preoperative strategy. Neoadjuvant sequence may increase the achievement of R0 resection margins in borderline resectable tumours but also the proportion of patients who will receive chemotherapy. We report a case of borderline resectable PDAC treated with duodenopancreatectomy after neoadjuvant treatment consisting of chemotherapy and SBRT.

(BELG J MED ONCOL 2021;15(2):79-82)

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Precision therapy in pancreaticobiliary cancers: molecular testing for all?

BJMO - volume 14, issue 6, october 2020

J-L. van Laethem MD, PhD, L. Mans MD, A. Demols MD, PhD


Pancreaticobiliary cancers remain challenging to be treated due to aggressive biology and heterogeneous molecular patterns. Chemotherapy remains the backbone therapy, with two lines available in each cancer. Using targeted therapies in unselected populations has led to complete failure while currently used immunotherapy with anti-PD1 can only be active in instable tumours (MSI-High), a rare condition in these cancers. As recently reported, targeting specific genes in pancreaticobiliary cancers may significantly improve tumour control and offer new ways to manage them, in addition to conventional chemotherapies usually proposed in front line. Consequently, it is now more and more recommended to perform genetic and genomic testing of these tumours, searching for new druggable targets. Dedicated trials focusing on such enriched populations are currently ongoing.

(BELG J MED ONCOL 2020;14(6):274-9)

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