Recalibrating “Unresectable” in Pancreatic Cancer

Дата публикации: 01-09-2026 00:00:00

One-third of patients with pancreatic cancer present with localized yet unresectable disease from mesenteric arterial encasement, long-segment venous involvement, or both. In this issue of JAMA Surgery, Reyngold and colleagues report the Maximal Ablative Irradiation Because of Encasement (MAIBE) study, a phase 2 trial including 48 patients with locally advanced pancreatic cancer (LAPC), providing prospective evidence that ablative radiation after induction chemotherapy can bridge selected patients to resection. In this cohort with extensive vascular encasement, hypofractionated ablative radiotherapy (A-RT) achieved a 27% resection rate, 38% 2-year overall survival, 11% to 15% 2-year local progression, and no 90-day postoperative deaths.

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