Neoadjuvant Therapy vs. Surgery First in Operable Pancreatic Cancer: What the Evidence Shows

There’s an ongoing uncertainty among experts about whether neoadjuvant therapy or surgery first is best for patients with operable pancreatic cancer. Here’s what we know.

Pancreatic cancer remains one of the most lethal malignancies, with high recurrence rates even after curative resection. For patients with resectable disease, the standard approach has traditionally involved upfront surgery followed by adjuvant therapy. However, growing interest in neoadjuvant therapy—administering chemotherapy or chemoradiation before surgery—has prompted debate over whether this sequence could improve outcomes by targeting micro-metastases early and increasing the likelihood of complete tumor removal.