SY11-2 - Adjuvant Chemotherapy for Resected Pancreatic Cancer: Focusing on the Jsap Study

Abstract

Although approximately 20% of patients with pancreatic cancer (PC) undergo surgery, their prognosis is relatively poor, as most develop recurrences after resection. Adjuvant therapies have been used in attempts to improve the prognosis of these patients, but a consensus has not been established for many years. However, recently performed large-scale phase III studies, such as ESPAC-1 and CONKO-001, have revealed that adjuvant chemotherapy using 5-FU plus leucovorin or gemcitabine (GEM) improves the prognosis of PC patients after surgery. Furthermore, JASPAC-01, a phase III study conducted in Japan last year, has demonstrated that S-1 is superior to GEM for resected PC with respect to overall survival. Consequently, S-1 has become the standard adjuvant therapy for resected PC in Japan. In this presentation, we will review the latest information on clinical trials for adjuvant therapy and will report the results of studies conducted by our group (Japanese Study Group of Adjuvant Therapy for Pancreatic Cancer: JSAP). We recently performed a phase I/II study (JSAP03) of GEM and S-1 combination (GS) therapy for resected PC and are presently conducting a phase III study (JSAP04) comparing GEM vs. GS therapy. Although GS therapy did not demonstrate a significant survival benefit in a phase III study for unresectable advanced PC (GEST), its application in an adjuvant setting may be more appropriate, as previous studies have demonstrated high response rates against PC.