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ESMO 2025 | Assessing the effect of duration of neoadjuvant chemotherapy in PDAC
Michele Reni, MD, IRCCS San Raffaele Scientific Institute, Milan, Italy, highlights the implications of the CASSANDRA trial (NCT04793932), which evaluated short- versus long-course preoperative chemotherapy in resectable pancreatic ductal adenocarcinoma (PDAC). While the short regimen achieved a higher resection rate in the protocol population, it did not translate to better survival outcomes. Patients in the longer preoperative chemotherapy arm showed a difference and advantage in terms of overall survival in the long run, despite having a lower resection rate. This interview took place at the European Society for Medical Oncology (ESMO) 2025 Congress in Berlin, Germany.
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Transcript
In the intention to treat population, we did not observe any significant difference in terms of resection rate. However, in the protocol population, there was a significantly higher resection rate in the short preoperative chemotherapy arm. However, this is intriguing because this did not translate into a better survival. On the opposite, the longer preoperative chemotherapy arm had a difference and advantage in terms of the tail of the curves as opposed to the short...
In the intention to treat population, we did not observe any significant difference in terms of resection rate. However, in the protocol population, there was a significantly higher resection rate in the short preoperative chemotherapy arm. However, this is intriguing because this did not translate into a better survival. On the opposite, the longer preoperative chemotherapy arm had a difference and advantage in terms of the tail of the curves as opposed to the short. So the short was able to achieve more resections but overall survival in the long run was worse.
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