Pancreatic Cancer · Radiation Oncology
PREOPANC-1
In resectable or borderline resectable pancreatic cancer, does neoadjuvant gemcitabine-based chemoradiotherapy followed by surgery improve survival over upfront surgery?
Population
246 eligible patients with resectable or borderline resectable pancreatic cancer
5-year OS
20.5% vs 6.5%
Absolute improvement 14 points; NNT 8
Overall survival
HR 0.73
95% CI 0.56–0.96; P=.025
R0 resection
71% vs 40%
Absolute improvement 31 points
Absolute Effect
NNT: 8, based on 5-year overall survival. The absolute five-year survival improvement was 14 percentage points.
NNH: not quantifiable. No single fixed-time toxicity endpoint provides a defensible trial-level NNH.
Clinical interpretation
PREOPANC-1 supports the biological and clinical value of treating systemic and locoregional disease before pancreatic surgery in an appropriately selected population. The large R0-resection improvement is an important component of the overall benefit.
Primary source
Versteijne E, et al. J Clin Oncol. 2022.