Metastatic Pancreatic Cancer

Publication Date: August 5, 2020

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

...Diagnosis...

...Initial Assessment...

...se computerized tomography (CT) scan of the chest...

...e baseline performance status (PS), symptom bu...

...of care (to include a discussion of an a...

...tidisciplinary collaboration to formul...

...sting for actionable genomic alterations is...

...very patient with pancreatic cancer...


Treatment

...Treatment...

...First Line...

...RINOX (leucovorin, fluorouracil, irinote...

...mcitabine plus NAB-paclitaxel is recommended fo...

...emcitabine alone is recommended for patien...

Patients with an ECOG PS 3 or with po...


Tr...

...patients with tumors harboring NTRK fusions,...

...1 immune checkpoint inhibitor pembrolizu...

...ho have a germline BRCA1 or BRCA2 mutation...

...lus NAB-paclitaxel may be offered...

...s nanoliposomal irinotecan, or fluorouracil p...

...rouracil plus oxaliplatin may be consid...

...or fluorouracil can be considered as...

...data are available to recommend third-li...


...Palliative Care...

...tastatic pancreatic cancer should have a full...


...Treatment of Pain...

...ents with metastatic pancreatic cance...


Follow-Up

...Follow-Up...

...active cancer-directed therapy outside a clini...


...the duration of cancer-directed therapy. An on...