The mainstay treatment for pancreatic cancer has classically been surgical resection. However, with the adoption of multimodal therapy, the 5-year survival rates have improved from 5% to 10% over the past 2 decades. Thanks to robust clinical trials, there is strong evidence to support the use of adjuvant chemoradiation for pancreatic cancer. Neoadjuvant therapy (NAT), however, is emerging as a potential strategy to further improve survival and outcomes. The purpose of this review is to provide a historical background of the use of multimodal therapy in the treatment of pancreatic cancer, as well as to explore the latest clinical questions regarding NAT in pancreatic cancer treatment. This article reviews the latest evidence in neoadjuvant treatment, discusses ongoing clinical trials, and provides insight on future directions of multimodal therapy for pancreatic cancer.
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