Surgical removal of the tumor is the only option for cure in pancreatic cancer. However, only 15-20% of patients are resectable and will be offered surgery and a chance for long-term survival.

Chemotherapy is an important part of the treatment sequence in patients undergoing surgery. It is under debate whether chemotherapy should be given before the operation (neoadjuvant) or only after the operation (adjuvant).

In addition, some international studies show that a proportion of patients with locally advanced pancreatic cancer, who are usually considered unresectable, can be offered surgery if shrinkage (down-sizing) of the tumor is achieved with chemotherapy.

In recent years, the Norwegian pancreatic cancer centers have conducted two clinical trials: NorPACT-1 (2017-2021) and NorPACT-2 (2018-2023). NorPACT-1 evaluates whether neoadjuvant chemotherapy improves survival in patients with primary resectable disease. NorPACT-2 investigates the effect of new cytotoxic regimens on resectability and survival in patients with borderline resectable and locally advanced pancreatic cancer who have involvement of major intra-abdominal vasculature.

The Norwegian research network has developed a good collaboration with Nordic and international centers. We are actively working to initiate and participate in new clinical trials as a continuation of NorPACT.