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
...Diagno...
...Initial Ass...
...tiphase computerized tomography (CT) scan of the...
...eline performance status (PS), sympto...
...care (to include a discussion of an advance di...
...linary collaboration to formulate treat...
...for actionable genomic alterations is...
...very patient with pancreatic cancer...
Treatment
...Treat...
...First Line Treatm...
...eucovorin, fluorouracil, irinotecan, and oxal...
...us NAB-paclitaxel is recommended for patients...
...mcitabine alone is recommended for p...
...tients with an ECOG PS 3 or with poorly contr...
...Treatment Options Fo...
In patients with tumors harboring NTRK...
...-1 immune checkpoint inhibitor pembrolizumab is...
...have a germline BRCA1 or BRCA2 mutatio...
...ne plus NAB-paclitaxel may be offered as second...
...orouracil plus nanoliposomal irinotecan, or...
...lus oxaliplatin may be considered as second-lin...
...or fluorouracil can be considered as second-line...
...lable to recommend third-line (or greate...
...Palliative Care...
...th metastatic pancreatic cancer should have a fu...
...Treatme...
...metastatic pancreatic cancer should...
Follow-Up
...Follow-Up...
...patients on active cancer-directed the...
...t on the duration of cancer-directed therapy. An...