Adjuvant and neoadjuvant approaches to treat surgically resectable pancreatic cancer.

Adjuvant therapy for pancreatic cancer is currently a controversial topic. Very little is known about the potential components of adjuvant therapy. All published randomized trials evaluating adjuvant therapy for pancreatic cancer have limitations that prevent the establishment of an absolute "standard of care." However, with the recent report of Charite Onkologie Clinical Studies in Gastrointestinal Cancer in abstract form and European Study Group for Pancreatic Cancer-1, it is clear that chemotherapy has an effect as adjuvant therapy. The role of radiation remains unclear. The future of adjuvant therapy is dependent on the investigators designing better trials that answer the important remaining questions: the role of radiation therapy, the integration of newer agents, and the best regimen of those currently available.