Radiation Oncologist Dr. Geertjan van Tienhoven of Cancer Center Amsterdam, one of the lead researchers: “We saw an increase in five-year survival from 6.5 percent to 20.5 percent by administering chemotherapy and radiation before the operation.” In others words: the chance for patients to still be alive after five years was 1 in 15 with the standard treatment. After the new treatment, this was 1 in 5. “We are pleased that we can now treat some of the patients better.”
Looking for better results
The standard treatment for patients with pancreatic cancer where the tumor can be removed is surgery and then chemotherapy for six months. Despite this intensive treatment, the cancer often returns. To improve outcome, researchers looked at whether part of the chemotherapy in combination with radiation prior to surgery (called neoadjuvant chemoradiation) could improve survival rates. This was the aim of the National Dutch PREOPANC (PREOperative radiochemotherapy versus immediate surgery for resectable and borderline resectable PANCreatic cancer) study led by Professor Casper van Eijck from Erasmus MC and Dr. Geertjan van Tienhoven and initiated by the Dutch Pancreatic Cancer Group.
1 in 5 still alive after five years
From 2013 to 2017, 246 patients from 16 Dutch hospitals specialized in the treatment of pancreatic cancer participated in the PREOPANC study. Patients were randomized to receive the standard treatment (the immediate surgery group, 127 patients) or to receive chemoradiation first (the neoadjuvant group, 119 patients).
Initial results of the PREOPANC trial failed to demonstrate a statistically significant overall survival benefit. But in the long run, the five-year survival rate was clearly better in the neoadjuvant group. Dr. Van Tienhoven: “After these positive results, the Dutch Pancreatic Cancer Group is conducting the randomized studies PREOPANC-2 and -3 in search for better treatment schedules for patients with pancreatic cancer.”
For more information contact us at CCA@amsterdamumc.nl, or read the full study here:
Eva Versteijne, et al. (2022) Neoadjuvant Chemoradiotherapy Versus Upfront Surgery for Resectable and Borderline Resectable Pancreatic Cancer: Long-Term Results of the Dutch Randomized PREOPANC Trial. Journal of Clinical Oncology, DOI: 10.1200/JCO.21.02233.
Professionals from Cancer Center Amsterdam involved in this study:
Eva Versteijne
Hanneke (JW) Wilmink
Marc G. Besselink
Olivier R. Busch
Koos (AH) Zwinderman
Geertjan van Tienhoven