Chawla A, Molina G, Pak LM, et al. - Researchers examined how neoadjuvant therapy affects the survival of patients with borderline-resectable pancreatic ductal adenocarcinoma (PDAC). The National Cancer Database yielded data of 7,730 patients with resectable PDAC and 1,980 patients with borderline-resectable PDAC from 2004 to 2015. Patients with resectable PDAC and patients with borderline-resectable disease treated with neoadjuvant therapy showed similar median overall survival (mOS) (26.5 vs 25.7 months). mOS was higher for patients with borderline-resectable disease treated with neoadjuvant therapy vs borderline-resectable patients treated with adjuvant therapy alone (25.7 vs 19.6 months). Patients with borderline-resectable disease who received neoadjuvant therapy vs those who received adjuvant therapy alone less frequently had node-positive pancreatic cancer (40.6% vs 76.3%) and margin-positive resections (17.8% vs 44.4%). These findings support the association of neoadjuvant therapy with enhanced survival in patients with borderline-resectable pancreatic cancer, which may be attributed to tumor downstaging.