Adjuvant Therapy in Pancreatic Ductal Adenocarcinoma—Past, Present, and Future

Andy Tran; Tejeshwar Jain; Naomi Fei; Vikas Dudeja

doi:10.3390/cancers18172754

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Adjuvant Therapy in Pancreatic Ductal Adenocarcinoma—Past, Present, and Future

Journal article

Open access

Peer reviewed

Adjuvant Therapy in Pancreatic Ductal Adenocarcinoma—Past, Present, and Future

Andy Tran, Tejeshwar Jain, Naomi Fei and Vikas Dudeja

Cancers, Vol.18(17), 2754

08/25/2026

DOI: 10.3390/cancers18172754

PMCID: PMC13565269

PMID: 42738277

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Abstract

Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies despite advances in surgical techniques and systemic therapy. Although surgical resection offers the only potential for cure, recurrence is common, underscoring the critical role of multimodal treatment. Over the past two decades, numerous clinical trials have cemented adjuvant chemotherapy as a cornerstone of multimodal management in resected PDAC, with progressive evolution from single-agent regimens to modern multiagent regimens. In contrast, the role of chemoradiation remains debated, with the body of evidence demonstrating conflicting results. Ongoing clinical trials are expected to elucidate optimal treatment modalities. Emerging targeted therapies, biomarker-directed treatment approaches, and immunotherapeutic strategies also hold promise for improving outcomes in select patient populations. This narrative review summarizes the landmark trials that have shaped adjuvant therapy, examines the evolution of adjuvant treatment over time, reviews current management guidelines, and highlights promising emerging therapeutic directions likely to influence the management of localized pancreatic cancer.

pancreatic cancer

pancreatic adenocarcinoma

adjuvant therapy

chemotherapy

radiation

immunotherapy

Details

Title: Subtitle: Adjuvant Therapy in Pancreatic Ductal Adenocarcinoma—Past, Present, and Future
Creators: Andy Tran - University of Iowa
Tejeshwar Jain - University of Alabama at Birmingham
Naomi Fei - University of Iowa
Vikas Dudeja - University of Iowa
Resource Type: Journal article
Publication Details: Cancers, Vol.18(17), 2754
DOI: 10.3390/cancers18172754
PMID: 42738277
PMCID: PMC13565269
NLM abbreviation: Cancers (Basel)
ISSN: 2072-6694
eISSN: 2072-6694
Publisher: MDPI
Language: English
Date published: 08/25/2026
Academic Unit: Anatomy and Cell Biology; Hematology, Oncology, and Blood & Marrow Transplantation; Surgery; Internal Medicine
Record Identifier: 9985220942102771

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