{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T12:43:58Z","timestamp":1793105038135,"version":"4.5.0"},"reference-count":45,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Surg"],"published-print":{"date-parts":[[2025,2,1]]},"abstract":"<jats:sec id=\"ab-soi240086-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Neoadjuvant therapy (NT) is an increasingly used treatment strategy for patients with localized pancreatic ductal adenocarcinoma (PDAC). Little research has been conducted on cancer care delivery during NT, and the standards for optimal delivery of NT have not been defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-soi240086-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop consensus best practices for delivering NT to patients with localized PDAC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-soi240086-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This study used a modified Delphi approach consisting of 2 rounds of voting, and a series of virtual conferences (from October to December 2023) to reach expert consensus on candidate best practice statements generated from a systematic review of the literature and expert opinion. An interdisciplinary panel was formed including 47 North American experts from surgical, medical, and radiation oncology, radiology, pathology, gastroenterology, integrative oncology, anesthesia, pharmacy, nursing, cancer care delivery research, and nutrition as well as patient and caregiver stakeholders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-soi240086-7\">\n                    <jats:title>Main Outcome and Measures<\/jats:title>\n                    <jats:p>Statements that reached 75% agreement or greater were included in final consensus statements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-soi240086-8\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 47 participating panel members, 27 (57.64%) were male, and the mean (SD) age was 47.6 (8.2) years. Physicians reported completing training a mean (SD) 14.6 (8.6) years prior and seeing a mean (SD) 110.6 (38.4) patients with PDAC annually; 35 (77.7%) were in academic practice. Final consensus was reached on 82 best practices for delivering NT. Of these, 38 statements focused on pre-NT practices, including diagnosis and staging (n\u2009=\u200915), evaluation and optimization (n\u2009=\u200920), and decision-making (n\u2009=\u20093); 29 statements defined best practices during NT, including initiation (n\u2009=\u20093), delivery of therapy (n\u2009=\u20098), restaging practices (n\u2009=\u200912), and management of complications during NT (n\u2009=\u20096); and 15 best practices were identified to guide treatment post-NT, focusing on surgery (n\u2009=\u20097), pathology (n\u2009=\u20094), and follow-up (n\u2009=\u20093).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-soi240086-9\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Using a modified Delphi consensus technique, best practice guidelines were developed focusing on the optimal standards for delivering NT to patients with localized PDAC. Given the prognostic importance of completing multimodality therapy, efforts to standardize and optimize the delivery of NT represent an immediate opportunity to decrease care variation and improve outcomes for patients with PDAC. Future research should focus on validating and implementing best practice standards into clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamasurg.2024.5191","type":"journal-article","created":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T11:00:53Z","timestamp":1733310053000},"page":"172","source":"Crossref","is-referenced-by-count":16,"title":["Best Practices for Delivering Neoadjuvant Therapy in Pancreatic Ductal Adenocarcinoma"],"prefix":"10.1001","volume":"160","author":[{"given":"Jordan M.","family":"Cloyd","sequence":"first","affiliation":[{"name":"Division of Surgical Oncology, The Ohio State University Wexner Medical Center, Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Sarna","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, The Ohio State University Wexner Medical Center, Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Arango","sequence":"additional","affiliation":[{"name":"The Ohio State University Wexner Medical Center, Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan E.","family":"Bates","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoop S.","family":"Bhutani","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center, Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Bloomston","sequence":"additional","affiliation":[{"name":"South Florida Surgical Oncology, Fort Myers"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Chung","sequence":"additional","affiliation":[{"name":"City of Hope, Duarte, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efrat","family":"Dotan","sequence":"additional","affiliation":[{"name":"Fox Chase Cancer Center, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina R.","family":"Ferrone","sequence":"additional","affiliation":[{"name":"Cedars-Sinai, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia F.","family":"Gambino","sequence":"additional","affiliation":[{"name":"Abramson Cancer Center, University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajit H.","family":"Goenka","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karyn A.","family":"Goodman","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William A.","family":"Hall","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin, Milwaukee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"He","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa E.","family":"Hogg","sequence":"additional","affiliation":[{"name":"NorthShore University HealthSystem, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiva","family":"Jayaraman","sequence":"additional","affiliation":[{"name":"St Joseph\u2019s Health Centre Toronto, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avinash","family":"Kambadakone","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew H. 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