PREOPANC-2

NCT04927780 📎

Regimen

Experimental
Total neoadjuvant FOLFIRINOX (oxali 85 + iri 180 + LV 400 + 5-FU 400 bolus + 2400 46h) q2w x 8 cycles, then surgery without adjuvant.
Control
Neoadjuvant gemcitabine + 36 Gy/15 fx chemoradiation (PREOPANC-1 regimen) followed by surgery + 4 cycles adjuvant gemcitabine.

Population

Resectable or borderline resectable PDAC, ECOG 0-1, Dutch multicenter, enrolled 2018-2021.

Key finding

PREOPANC-2 showed total neoadjuvant FOLFIRINOX does not improve OS vs neoadjuvant gemcitabine-chemoradiation + adjuvant gemcitabine in resectable/borderline PDAC. Both arms delivered similar outcomes, supporting either approach but failing to establish FOLFIRINOX-only neoadjuvant as clearly superior.

Source: PMID 40945523

Timeline