After eight cycles of modified FOLFIRINOX for initially locally advanced pancreatic adenocarcinoma, restaging shows no metastases and disappearance

Question

After eight cycles of modified FOLFIRINOX for initially locally advanced pancreatic adenocarcinoma, restaging shows no metastases and disappearance of arterial encasement. The patient remains ECOG 0. What is the next best step?

Accepted Answer

Specialist pancreatic MDT reassessment, staging laparoscopy if indicated and resection if feasible

Answer

Change to gemcitabine-capecitabine maintenance without a specialist surgical assessment

Answer

Proceed directly to definitive chemoradiotherapy without repeat surgical staging

Answer

Observe off treatment for three months before reconsidering potential local therapy

Answer

Continue modified FOLFIRINOX to maximal cumulative toxicity before reassessing local therapy

Pancreatic Cancer — SCE Medical Oncology MCQ

After eight cycles of modified FOLFIRINOX for initially locally advanced pancreatic adenocarcinoma, restaging shows no metastases and disappearance of arterial encasement. The patient remains ECOG 0. What is the next best step?