Surgical removal of the tumour is the only option for cure in pancreatic cancer. However, only 15-20% of patients are resectable and will be offered surgery and a chance for long-term survival.
Chemotherapy is an important part of the treatment sequence in patients undergoing surgery. It is under debate whether chemotherapy should be given before the operation (neoadjuvant) or only after the operation (adjuvant).
In addition, some international studies show that a proportion of patients with locally advanced pancreatic cancer, who are usually considered unresectable, can be offered surgery if shrinkage (down-sizing) of the tumour is achieved with chemotherapy.
In recent years, the Norwegian pancreatic cancer centres have conducted two clinical trials: NorPACT-1 (2017-2021) and NorPACT-2 (2018-2023). NorPACT-1 evaluates whether neoadjuvant chemotherapy improves survival in patients with primary resectable disease. NorPACT-2 investigates the effect of new cytotoxic regimens on resectability and survival in patients with borderline resectable and locally advanced pancreatic cancer who have involvement of major intraabdominal vasculature.
The Norwegian research network has developed a good collaboration with Nordic and international centres. We are actively working to initiate and participate in new clinical trials as a continuation of NorPACT.
Collaborators
- Jon Erik Grønbech/Erling Bringeland, St. Olavs Hospital, Trondheim, Norway
- Dag Hoem/Jon Helge Angelsen, Haukeland University Hospital, Bergen, Norway
- Kim Mortensen/Linn Nymo, University Hospital of Northern Norway, Tromsø, Norway
- Kjetil Søreide/Oddvar Sandvik, Stavanger University Hospital, Stavanger, Norway
- Kristoffer Lassen/Olav Dajani/Svein Dueland, Oslo University Hospital, Oslo, Norway
- Svein Olav Bratlie, Sahlgrenska University Hospital, Gothenburg and Swedish Study Group for Pancreatic Cancer, Sweden (NorPACT-1)
- Per Pfeiffer, Odense University Hospital, Odense and Danish Pancreatic Cancer Group, Denmark (NorPACT-1)
- Ville Sallinen, Helsinki University Hospital, Finland (NorPACT-1)
- Marc Besselink, Amsterdam University Medical Centers, the Netherlands and European Consortium on Minimally Invasive Pancreatic Surgery (DIPLOMA trial)