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

...agnosis

...ial Assessment...

...puterized tomography (CT) scan of the...

...performance status (PS), symptom burde...

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

...linary collaboration to formulate treatment and c...

...testing for actionable genomic alterations i...

...ith pancreatic cancer should be offe...


Treatment

Treatmen...

...Line Treatment...

...RINOX (leucovorin, fluorouracil, irinotecan,...

...NAB-paclitaxel is recommended for patients who m...

...e alone is recommended for patients...

...with an ECOG PS 3 or with poorly controlled com...


...ons Following First-Line Therapy...

...ents with tumors harboring NTRK fusions, trea...

...immune checkpoint inhibitor pembrolizumab is...

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

...tabine plus NAB-paclitaxel may be offered as...

...rouracil plus nanoliposomal irinotecan, or...

...uorouracil plus oxaliplatin may be considered a...

...abine or fluorouracil can be considere...

...re available to recommend third-line (or greate...


...alliative Care...

...h metastatic pancreatic cancer should have a ful...


...ent of Pain and Symptom...

...atients with metastatic pancreatic cancer should...


Follow-Up

...llow-Up

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


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