Pancreatic adenocarcinoma is a rapidly lethal disease process for which, surgical resection is currently the only potential curative treatment. In order to maximize the number of patients able to undergo resection and to maximize the outcome of the procedure itself, extensive research has been completed on potential neoadjuvant therapies for pancreatic cancer. Several sources have confirmed that neoadjuvant therapy can improve the oncologic quality of resection in borderline pancreatic cancer patients and even potentially convert those with locally advanced disease. This article reviews the pros and cons of neoadjuvant therapy in pancreatic cancer, the definitions of resectable, borderline resectable, and locally advanced pancreatic cancer, and the significant studies and current recommendations for the use of neoadjuvant treatment with radiation, chemotherapy, chemoradiation, and/or targeted therapies.
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