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...
Initial Asses...
...tiphase computerized tomography (CT) scan of...
...formance status (PS), symptom burden, and c...
...goals of care (to include a discu...
...iplinary collaboration to formulate...
...ing for actionable genomic alterations is...
...t with pancreatic cancer should be offered inform...
Treatment
...reatme...
...Line Treatment...
...LFIRINOX (leucovorin, fluorouracil, irin...
...e plus NAB-paclitaxel is recommended for pat...
...e alone is recommended for patients who have eith...
...h an ECOG PS 3 or with poorly controlled como...
...tions Following First-Line Therapy...
...tients with tumors harboring NTRK fusions, t...
...une checkpoint inhibitor pembrolizumab...
In patients who have a germline BRCA1 or BR...
...NAB-paclitaxel may be offered as second-line...
...l plus nanoliposomal irinotecan, or fluorouracil p...
...lus oxaliplatin may be considered as second-line...
...e or fluorouracil can be considered as...
...available to recommend third-line (or greater...
Palliative...
Patients with metastatic pancreatic cancer...
...ent of Pain and Symptoms
...metastatic pancreatic cancer should b...
Follow-Up
...llow-Up
...active cancer-directed therapy ou...
...o data exist on the duration of cance...