FOLFIRINOX treatment leading to pathologic complete response of a locally advanced pancreatic cancer

Pancreatic cancer (PC) is a lethal disease and commonly asymptomatic. Therefore, it is most often diagnosed at an advanced stage (1). Symptoms arise if the tumor is located close to the common bile duct (CBD) causing obstructive jaundice. Up to date, PC is the fourth leading cause of cancer related deaths (2). Surgical resection is the single curative option (1,3). However, surgery is possible in less than 20% of the patients. A locally unresectable tumor is present in 30% of the cases, whereas the majority presents with distant metastases (1). Unresectable PC can be divided into locally advanced PC (LAPC) and borderline resectable PC (BRPC). LAPC is defined as a surgically unresectable tumor encasing the adjacent arteries [celiac axis, superior mesenteric artery (SMA)] or occluding the adjacent veins (portal vein, superior mesenteric vein) (4). BRPC is a tumor bordering less than 50% of the circumference of the SMA, celiac axis, and short segment abutment, encasement of the common hepatic artery or segmental venous occlusion