Neoadjuvant quadruplet chemotherapy PAXG for pancreatic cancer
Mené en Italie sur 132 patients atteints d'un adénocarcinome canalaire du pancréas, résécable ou à la limite de la résécabilité (âge : 18-75 ans), cet essai de phase III compare l'efficacité, du point de vue de la survie sans événement, et la toxicité d'une chimiothérapie périopératoire de type mFOLFIRINOX et de type PAXG (cisplatine, nab-paclitaxel, capécitabine et gemcitabine)
Perioperative management of localised pancreatic ductal adenocarcinoma (PDAC) is informed by resectability criteria, which consider anatomy together with biological and clinical factors.1 In patients with resectable PDAC, adjuvant mFOLFIRINOX (modified 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) is a standard of care;2,3 however, many are unable to receive this regimen due to inadequate performance status after surgery. Trials have evaluated various neoadjuvant chemotherapy regimens; notably, two randomised controlled trials did not confirm superiority of mFOLFIRINOX or FOLFIRINOX over gemcitabine–nab-paclitaxel (SWOG 1505)4 and gemcitabine with radiation (PREOPANC-2).
The Lancet , commentaire, 2025