Locally advanced pancreatic cancer treated with surgical resection after chemotherapy

Pancreatic cancer is a malignancy with poor prognosis and overall poor response to systemic therapy. Moreover, patients with locally advanced or unresectable tumours have historically worse outcomes compared with those with earlier stages of disease. We report a case of a female patient in the fourth decade with locally advanced pancreatic adenocarcinoma, who received 12 cycles modified FOLFIRINOX (mFOLFIRINOX: fluorouracil/leucovorin/irinotecan/oxaliplatin) chemotherapy, followed by pancreaticoduodenectomy, resulting in a near complete pathological response after definitive surgical treatment. Given the lack of indication for adjuvant therapy, she is considered in remission. The case demonstrates that potentially curative surgical resection can be a viable and sought-after treatment option for patients with locally advanced and/or metastatic pancreatic cancer, as it is not readily available for many patients due to the disease's aggressive nature and presence of advanced stage at diagnosis. It holds meaningful implications for clinical practice and promotes considerations in future advancements in treatment strategies.