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
...iagnos...
...itial Assessm...
...mputerized tomography (CT) scan of the chest, a...
...ine performance status (PS), symptom burden, a...
The goals of care (to include a discussion of an a...
...inary collaboration to formulate trea...
...g for actionable genomic alterations i...
...ient with pancreatic cancer should be offer...
Treatment
...reatment
First-Line Treatmen...
...OX (leucovorin, fluorouracil, irinotecan, and ox...
...s NAB-paclitaxel is recommended for patients w...
...mcitabine alone is recommended for patients who...
...ts with an ECOG PS 3 or with poorly controlled...
...t Options Following First-Line Therapy...
...ith tumors harboring NTRK fusions, treatment with...
...ckpoint inhibitor pembrolizumab is recommended...
...o have a germline BRCA1 or BRCA2 mut...
...s NAB-paclitaxel may be offered as second-line t...
...s nanoliposomal irinotecan, or fluor...
...il plus oxaliplatin may be considered as second-li...
...citabine or fluorouracil can be considered as seco...
...vailable to recommend third-line (or greater) the...
...lliative Care...
...with metastatic pancreatic cancer sh...
...tment of Pain and Sympt...
...h metastatic pancreatic cancer should be offe...
Follow-Up
...llow-U...
...w-up/Surveillanc...
...on active cancer-directed therapy o...
No data exist on the duration of canc...