Adverse events after treatment with neoadjuvant gemcitabine plus S-1 and their management in patients with resectable T3 pancreatic cancer

Abstract

There has been a pressing need to develop the optimal regimen for neoadjuvant chemotherapy (NAC) for patients with pancreatic cancer (PC). Recently, surgical resection after neoadjuvant gemcitabine plus S-1 (GS) compared with upfront surgery in patients with resectable PC, showed significantly better overall survival in the Prep-02/JSAP05 study. We conducted a retrospective analysis of patients with resectable T3 PC who underwent neoadjuvant GS to evaluate the safety and effectiveness of neoadjuvant GS in a real-world setting. A total of 22 patients received neoadjuvant GS between July 2019 and June 2020. Major Grade 3-4 toxicities included neutropenia (55%), thrombocytopenia (9.1%), oral stomatitis (9.1%) and skin rash (4.5%). The reasons for treatment failure were unacceptable toxicities in 4 patients. The resection rate was 100% and R0 resection rate was 96%. Neoadjuvant GS in patients with resectable T3 PC may increase the chance for curative resection, but it is important to prevent and mange adverse events appropriately.