Quimioterapia neoadjuvante no manejo do câncer pancreático limítrofe e localmente avançado: uma revisão de escopo

Introduction: Pancreatic cancer is highly lethal and frequently diagnosed at advanced stages, which limits therapeutic options and reduces survival. Classification of tumors into resectable, borderline resectable (BRPC) and locally advanced unresectable (LAPC) is crucial for therapeutic planning, although only 20% of cases are resectable at diagnosis. Objective: to analyze neoadjuvant treatments for patients with borderline and locally advanced pancreatic cancer. Methods: It consists of a scoping review performed through the Scopus, PubMed® and SciELO databases, using the descriptors: borderline pancreatic cancer, locally advanced pancreatic cancer, neoadjuvant treatment. Studies published in the last 6 years, in English, Spanish or Portuguese, that addressed the topic were included. Results and discussions: FOLFIRINOX was more effective, with better resection rates and overall survival, but caused greater toxicity. Gemcitabine + nab-paclitaxel showed good results when combined with surgery and adjuvant therapy, but with a lower resection rate. Conclusion: Although overall survival was similar between the two regimens, FOLFIRINOX remains preferred due to its greater efficacy. The review highlighted the need for further studies with homogeneous samples and prolonged follow-up, in addition to strategies to reduce toxicity and personalize treatments.