Neoadjuvant mFOLFIRINOX with or without hypofractionated radiotherapy for borderline resectable PDAC

Guidelines endorse neoadjuvant therapy for borderline resectable pancreatic ductal adenocarcinoma (PDAC), but the optimal strategy remains unclear. The multicenter randomized phase 2 A021501 trial compared neoadjuvant mFOLFIRINOX with or without hypofractionated radiotherapy for borderline resectable PDAC with historical data. Neoadjuvant mFOLFIRINOX alone was associated with favorable overall survival, which was not seen with neoadjuvant mFOLFIRINOX plus hypofractionated radiotherapy. The authors conclude that mFOLFIRINOX represents a reference neoadjuvant regimen for borderline resectable PDAC.