The Alliance for Clinical Trials in Oncology A021501 trial,
which is expected to activate across NCTN sites in early
summer 2016, will compare two more intensive preoperative
therapy regimens for patients with more advanced disease.
1. Verbeke CS, Leitch D, Menon KV,
McMahon MJ, Guillou PJ, Anthoney
A. Redefining the R1 resection
in pancreatic cancer. Br J Surg.
2006; 93( 10):1232-1237.
2. Oettle H, Post S, Neuhaus P, et
al. Adjuvant chemotherapy with
gemcitabine vs observation in patients
undergoing curative-intent resection
of pancreatic cancer: A randomized
controlled trial. JAMA. 2007;297( 3):267-
3. Abrams RA. RTOG 0848: A phase IIR
and a phase III trial evaluating both
erlotinib (Ph IIR) and chemoradiation
(Ph III) as adjuvant treatment for
patients with resected head of
pancreas adenocarcinoma. February
2014. Available at: www.rtog.org/
Clinical Trials/Protocol Table/
Accessed June 23, 2016.
4. Katz MH, Shi Q, Ahmad SA, et al.
Preoperative modified FOLFIRINOX
treatment followed by capecitabine-based chemoradiation for borderline
resectable pancreatic cancer: Alliance
for Clinical Trials in Oncology Trial
A021101. JAMA Surg. June 2016 [Epub
ahead of print].
5. Katz MH, Ahmad SA, Boughey
JC. Improving resection rates in
borderline resectable pancreatic
cancer: Pilot study shows
favorable results. Bull Am Coll Surg.
2015;100( 10): 39-41. Available at:
Accessed June 23, 2016.
All patients with localized
pancreatic cancer should be
considered for enrollment in
one of these two noncompeting
trials. The SWOG study
specifically is for patients
with technically resectable
cancers—cancers that meet the
following radiographic criteria:
•No involvement of the celiac
artery, common hepatic artery,
or superior mesenteric artery
•No involvement, or < 180°
interface between tumor and
vessel wall, of the portal vein or
superior mesenteric vein; and
patent portal vein/splenic vein
•No evidence of metastatic
In contrast, the Alliance
study is specifically for
patients with borderline
resectable cancers defined by
one or more of the following
•A circumferential tumor-vessel
interface (TVI) with superior
mesenteric/portal vein ≥ 180°
• TVI with superior mesenteric
artery < 180°
•Short-segment TVI with hepatic
artery of any degree
The ability of these trials to
advance the management
of pancreatic cancer will
depend in large part upon the
enthusiastic participation of
surgeons and their patients with
their multidisciplinary teams.
For questions and additional
information, contact Matthew
H. G. Katz at mhgkatz@
mdanderson.org or Syed A.
Ahmad at email@example.com. ♦