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
...gnosis...
...al Assessment...
...puterized tomography (CT) scan of the chest, abdom...
...baseline performance status (PS), sy...
...goals of care (to include a discussion of a...
...ry collaboration to formulate treat...
...ng for actionable genomic alterations is recom...
...tient with pancreatic cancer should be offered in...
Treatment
...eatment...
...-Line Treatment...
...RINOX (leucovorin, fluorouracil, irinotecan,...
...ne plus NAB-paclitaxel is recommended f...
...one is recommended for patients who have...
...with an ECOG PS 3 or with poorly controlled com...
...t Options Following First-Line Therapy...
...atients with tumors harboring NTRK fusions, treat...
...kpoint inhibitor pembrolizumab is r...
...ients who have a germline BRCA1 or BRCA2 mutat...
...abine plus NAB-paclitaxel may be offered as second...
...luorouracil plus nanoliposomal irinotecan,...
...luorouracil plus oxaliplatin may be consi...
...or fluorouracil can be considered as sec...
...o data are available to recommend third-li...
...alliative Care
...atients with metastatic pancreatic cancer sho...
...ent of Pain and Symptom...
...s with metastatic pancreatic cancer should be off...
Follow-Up
...low-Up
...ow-up/Surveillance
...atients on active cancer-directed ther...
...n the duration of cancer-directed therapy....