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Metastatic Pancreatic Cancer: ASCO Clinical Practice Guideline Update.

Publication ,  Journal Article
Sohal, DPS; Kennedy, EB; Khorana, A; Copur, MS; Crane, CH; Garrido-Laguna, I; Krishnamurthi, S; Moravek, C; O'Reilly, EM; Philip, PA; Shah, MA ...
Published in: J Clin Oncol
August 20, 2018

Purpose In 2016, ASCO published a guideline to assist in clinical decision making in metastatic pancreatic cancer for initial assessment after diagnosis, first- and second-line treatment options, palliative and supportive care, and follow-up. The purpose of this update is to incorporate new evidence related to second-line therapy for patients who have experienced disease progression or intolerable toxicity during first-line therapy. Methods ASCO convened an Expert Panel to conduct a systematic review of the literature on second-line therapy published between June 2015 and January 2018. Recommendations on other topics covered in the 2016 Metastatic Pancreatic Cancer Guideline were endorsed by the Expert Panel. Results Two new studies were found that met the inclusion criteria. Recommendations For second-line therapy, gemcitabine plus nanoparticle albumin-bound paclitaxel should be offered to patients with first-line treatment with FOLFIRINOX (leucovorin, fluorouracil, irinotecan, and oxaliplatin), an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 to 1, and a favorable comorbidity profile; fluorouracil plus nanoliposomal irinotecan can be offered to patients with first-line treatment with gemcitabine plus NAB-paclitaxel, an ECOG PS of 0 to 1, and a favorable comorbidity profile; fluorouracil plus irinotecan or fluorouracil plus oxaliplatin may be offered when there is a lack of availability of fluorouracil plus nanoliposomal irinotecan; gemcitabine or fluorouracil should be offered to patients with either an ECOG PS of 2 or a comorbidity profile that precludes other regimens. Testing select patients for mismatch repair deficiency or microsatellite instability is recommended, and pembrolizumab is recommended for patients with mismatch repair deficiency or high microsatellite instability tumors. Endorsed recommendations from the 2016 version of this guideline for computed tomography, baseline performance status and comorbidity profile, defining goals of care, first-line therapy, and palliative care are also contained within the full guideline text. Additional information is available at www.asco.org/gastrointestinal-cancer-guidelines .

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Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

August 20, 2018

Volume

36

Issue

24

Start / End Page

2545 / 2556

Location

United States

Related Subject Headings

  • Practice Guidelines as Topic
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Neoplasm Metastasis
  • Male
  • Humans
  • Female
  • Clinical Decision-Making
  • Antineoplastic Combined Chemotherapy Protocols
  • 3211 Oncology and carcinogenesis
 

Citation

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MLA
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Sohal, D. P. S., Kennedy, E. B., Khorana, A., Copur, M. S., Crane, C. H., Garrido-Laguna, I., … Laheru, D. (2018). Metastatic Pancreatic Cancer: ASCO Clinical Practice Guideline Update. J Clin Oncol, 36(24), 2545–2556. https://doi.org/10.1200/JCO.2018.78.9636
Sohal, Davendra P. S., Erin B. Kennedy, Alok Khorana, Mehmet S. Copur, Christopher H. Crane, Ignacio Garrido-Laguna, Smitha Krishnamurthi, et al. “Metastatic Pancreatic Cancer: ASCO Clinical Practice Guideline Update.J Clin Oncol 36, no. 24 (August 20, 2018): 2545–56. https://doi.org/10.1200/JCO.2018.78.9636.
Sohal DPS, Kennedy EB, Khorana A, Copur MS, Crane CH, Garrido-Laguna I, et al. Metastatic Pancreatic Cancer: ASCO Clinical Practice Guideline Update. J Clin Oncol. 2018 Aug 20;36(24):2545–56.
Sohal, Davendra P. S., et al. “Metastatic Pancreatic Cancer: ASCO Clinical Practice Guideline Update.J Clin Oncol, vol. 36, no. 24, Aug. 2018, pp. 2545–56. Pubmed, doi:10.1200/JCO.2018.78.9636.
Sohal DPS, Kennedy EB, Khorana A, Copur MS, Crane CH, Garrido-Laguna I, Krishnamurthi S, Moravek C, O’Reilly EM, Philip PA, Ramanathan RK, Ruggiero JT, Shah MA, Urba S, Uronis HE, Lau MW, Laheru D. Metastatic Pancreatic Cancer: ASCO Clinical Practice Guideline Update. J Clin Oncol. 2018 Aug 20;36(24):2545–2556.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

August 20, 2018

Volume

36

Issue

24

Start / End Page

2545 / 2556

Location

United States

Related Subject Headings

  • Practice Guidelines as Topic
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Neoplasm Metastasis
  • Male
  • Humans
  • Female
  • Clinical Decision-Making
  • Antineoplastic Combined Chemotherapy Protocols
  • 3211 Oncology and carcinogenesis