PREOPANC-1 / PREOPANC-2
Dutch trials testing whether treating before surgery beats operating first. Chemoradiation first helped in the long run; FOLFIRINOX first did not clearly beat surgery-first with adjuvant chemotherapy.
PREOPANC-1: gemcitabine-based chemoradiation before surgery improved 5-year OS (20.5% vs 6.5%) despite a non-significant primary analysis. PREOPANC-2 (2023): neoadjuvant FOLFIRINOX did not improve OS versus neoadjuvant gemcitabine-chemoradiation. Together with ALLIANCE A021806 and NORPACT-1, they leave the neoadjuvant question open for resectable disease while borderline-resectable disease is generally treated neoadjuvantly.
- 20.5 vs 6.5 out of 100 alive with Neoadjuvant chemoradiotherapy, 5-year OS compared with Upfront surgery, 5-year OS; 14 more per 100.
- Roughly one extra person helped for every 7 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
- Put another way, the treated group had about 27 percent lower chance of the event at any given time (hazard ratio 0.73, likely range 0.56 to 0.96).
- Overall survival counts deaths from any cause, so it is the most direct measure of whether a treatment helps people live longer.
- These results apply to the people the trial enrolled: Resectable and borderline-resectable PDAC: neoadjuvant chemoradiation (PREOPANC-1) or neoadjuvant FOLFIRINOX (PREOPANC-2) vs upfront surgery. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
246 participants enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Overall survival (long-term)primary | Neoadjuvant chemoradiotherapy, 5-year OS | 119 | 20.5% | 0.73 (0.56–0.96) | 0.025 | link |
| Upfront surgery, 5-year OS | 127 | 6.5% |
Pages like this
not linked directly; found by shared links- TrialPRODIGE 24 / CCTG PA6
Shares FOLFIRINOX / mFOLFIRINOX, Pancreatic ductal adenocarcinoma.
- TrialNAPOLI 3
Shares FOLFIRINOX / mFOLFIRINOX, Pancreatic ductal adenocarcinoma.
- PersonAlbert C. Koong
Shares IMRT / IGRT (modern external beam), Pancreatic ductal adenocarcinoma.
- IdeaRAS(ON) inhibitors to convert unresectable pancreatic cancer to resectable
Shares FOLFIRINOX / mFOLFIRINOX, Pancreatic ductal adenocarcinoma.
- PersonTheodore S. Lawrence
Shares IMRT / IGRT (modern external beam), Pancreatic ductal adenocarcinoma.
- TechnologyIntraoperative radiotherapy (IORT)
Shares IMRT / IGRT (modern external beam), Pancreatic ductal adenocarcinoma.
- InstitutionTianjin Medical University Cancer Institute and Hospital
Shares IMRT / IGRT (modern external beam), Pancreatic ductal adenocarcinoma.
- TechnologyHypoxia-activated prodrugs
Shares IMRT / IGRT (modern external beam), Pancreatic ductal adenocarcinoma.