Metastatic Pancreatic Cancer
Key Points
Key Points
- There will be an estimated 57,600 new cases and 47,050 deaths as a result of pancreatic cancer in the United States in 2020. There were an estimated 460,000 new cases worldwide in 2018.
- A diagnosis of pancreatic ductal adenocarcinoma is associated with poor prognosis due to early micrometastatic spread.
- The 5-year survival rate for metastatic pancreatic cancer is approximately 2.9%.
- This 2020 update of the 2018 recommendations was triggered by:
- New evidence for PARP inhibitor olaparib as an option for maintenance therapy after first-line treatment and
- New studies of tissue agnostic agents that target fusions of the neurotrophin tyrosine receptor kinase (NTRK) 1/2/3 genes.
Diagnosis
...agnosi...
...itial Assessment...
...se computerized tomography (CT) sca...
...ne performance status (PS), symptom burden, and...
...goals of care (to include a discussion o...
...isciplinary collaboration to formulate tre...
...arly testing for actionable genomic alterations...
...y patient with pancreatic cancer should be...
Treatment
...eatment
...-Line Treatment...
...(leucovorin, fluorouracil, irinoteca...
...mcitabine plus NAB-paclitaxel is recommended for...
...emcitabine alone is recommended for p...
...s with an ECOG PS 3 or with poorly cont...
...eatment Options Following First-Line Therap...
...ents with tumors harboring NTRK fusions, treatment...
...ne checkpoint inhibitor pembrolizumab is...
...tients who have a germline BRCA1 or BRCA...
...citabine plus NAB-paclitaxel may be offered...
Fluorouracil plus nanoliposomal irin...
...us oxaliplatin may be considered as second...
...itabine or fluorouracil can be considered as sec...
...ata are available to recommend third...
...iative Care
...ents with metastatic pancreatic ca...
...of Pain and Symptoms...
...with metastatic pancreatic cancer should...
Follow-Up
Follow...
Follow-up/Surveilla...
...on active cancer-directed therapy outsi...
...n the duration of cancer-directed therapy...