• Yoshihiro Miyasaka, Takao Ohtsuka, Susumu Eguchi, Masafumi Inomata, Kazuyoshi Nishihara, Hiroyuki Shinchi, Koji Okuda, Hideo Baba, Hiroaki Nagano, Toshiharu Ueki, Hirokazu Noshiro, Masafumi Nakamura, and Kyushu study group of treatment for pancreatobiliary cancer.
• Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Japan.
• Int J Surg Protoc. 2021 Apr 26; 25 (1): 55-60.

IntroductionAlthough neoadjuvant treatment is recommended for patients with borderline resectable pancreatic cancer (BRPC), no standard neoadjuvant regimen has been established for BRPC with arterial involvement (BRPC-A), which is associated with a higher risk of margin-positive resection and poorer prognosis than BRPC with only venous involvement. Gemcitabine plus nab-paclitaxel (GnP) has been reported to significantly reduce tumor size in metastatic pancreatic cancer, and some retrospective studies suggested that neoadjuvant GnP for BRPC improved resectability and survival.Methods And AnalysisA prospective multicenter single-arm phase II study is conducted to evaluate the safety and efficacy of GnP as neoadjuvant chemotherapy for BRPC-A. The primary endpoint is the R0 resection rate. The secondary endpoints are the neoadjuvant chemotherapy response rate, resection rate, pathological response rate, incidence rate of adverse events, and quality of life.Ethics And DisseminationThis study protocol was approved by the institutional review board of Kyushu University (no. 181). The results will be published in a peer-reviewed journal and will be presented at medical meetings.HighlightsStrategy for borderline resectable pancreatic cancer involving arteries (BRPC-A).There is no standard regimen for neoadjuvant chemotherapy for BRPC-A.Gemcitabine plus nab-paclitaxel (GnP) shows significant tumor shrinkage.Neoadjuvant GnP for BRPC-A increases resectability and margin-negative resection.Copyright: © 2021 The Author(s).

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