The phase 3 PREOPANC-2 trial found no significant difference in median overall or progression-free survival between neoadjuvant FOLFIRINOX and gemcitabine-based chemoradiotherapy in resectable or borderline resectable pancreatic cancer. Both regimens showed comparable safety profiles. These results suggest that both treatments can be considered viable options for patients with resectable/borderline resectable pancreatic ductal adenocarcinoma.
Study
|
Multicentre, open-label, phase 3 randomised trial [PREOPANC-2] |
| Patients with resectable or borderline resectable pancreatic ductal adenocarcinoma |
| Neoadjuvant FOLFIRINOX (n=185) vs neoadjuvant gemcitabine-based chemoradiotherapy (n=184)
|
Efficacy
|
pCR: 10% vs. 5% |
| mOS: 21.9 mos vs 21.3 mos (HR 0.88 [0.69-1.13]) |
| mPFS: 12.1 mos vs 11.9 mos (HR 0.84 [0.67-1.06])
|
Safety
|
Grade >=3 AEs: neutropenia (25% vs 22%), diarrhoea (23% vs 1%), leukopenia (8% vs 15%) |
| Serious AEs: 49% vs 43% |
| Treatment-related deaths: 1% vs 1%
|
Lancet Oncol. Published online 2025
http://doi.org/10.1016/s1470-2045(25)00363-8
Reviewed by Ulas D. Bayraktar, MD on Oct 22, 2025
