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
...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...