The Future of Multidisciplinary Care in Pancreatic Cancer

Abstract

Neoadjuvant therapy for pancreatic cancer has become increasingly common for patients with localized disease. Although initial neoadjuvant trials were developed with the goal of identifying patients with treatment-resistant disease in whom surgical therapy would provide little oncologic benefit, the recent rapid adoption of neoadjuvant therapy has grown from the significant gains overall survival observed among patients who are able to complete all neoadjuvant therapy and surgery. Given the necessity of systemic chemotherapy to provide lasting disease control for patients with pancreatic cancer and the unpredictability of delivery adjuvant therapy following surgery, it is very possible that neoadjuvant therapy may become the preferred treatment sequence for all patients with localized pancreatic cancer in the near future. In contrast to adjuvant therapy, neoadjuvant therapy often requires engagement and cooperation of multiple specialty services to accurate stage, palliate, and treat patients with operable pancreatic cancer. The purpose of this chapter is to provide an overview of the breadth and depth of specialist required to provide neoadjuvant therapy to patients in the current era and to identify additional areas of unmet need which will need to be addressed in the future.