Updates in Clinical Management of Pancreatic Cancer

Presented by:
Andrew H. Ko
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 MD, FASCO
Volume/Issue:
Volume 22: Issue Supplement
Online Publication Date:
31 May 2024
DOI:
https://doi.org/10.6004/jnccn.2024.5019
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The mainstay of treatment for patients with metastatic pancreatic cancer is chemotherapy, but the development of targeted therapies and immunotherapies heralds a new era in their care. Although actionable alterations are detected infrequently, routine molecular testing should be performed in all patients. The NCCN Guidelines provide the current evidence-based recommendations for maintenance therapy in the metastatic setting. For patients with resectable, borderline resectable, and locally advanced or unresectable tumors, critical questions remain regarding the role of radiation therapy.

Disclosures: Dr. Ko has disclosed receiving grant/research support from AbGenomics Corporation, Apexigen, Inc., Astellas Pharma US, Inc., Biomed Valley Discoveries, Inc., Bristol Myers Squibb, Celgene Corporation, Genentech, Inc., Merck & Co., Inc., and Verastem Oncology; and serving as a scientific advisor for Aadi Bioscience Inc., Arcus Biosciences, Eisai Inc., FibroGen, Inc., Genentech, Inc., GRAIL, Ipsen, and Merus.

Correspondence: Andrew H. Ko, MD, FASCO, UCSF Helen Diller Family Comprehensive Cancer Center, 550 16th Street, Box 3211, San Francisco, CA 94143. Email: andrew.ko@ucsf.edu
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Print ISSN:
1540-1405
Online ISSN:
1540-1413
Publisher:
National Comprehensive Cancer Network
Cover Journal of the National Comprehensive Cancer Network
  • 1.

    Ohba A, Ozaka M, Ogawa G, et al. Nab-paclitaxel plus gemcitabine versus modified FOLFIRINOX or S-IROX in metastatic or recurrent pancreatic cancer (JCOG1611, GENERATE): a multicentred, randomized, open-label, three-arm, phase II/III trial. Ann Oncol 2023;34(Suppl 2):Abstract 1616O.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Wainberg ZA, Melisi D, Macarulla T, et al. NALIRIFOX versus nab-paclitaxel and gemcitabine in treatment-naive patients with metastatic pancreatic ductal adenocarcinoma (NAPOLI 3): a randomised, open-label, phase 3 trial. Lancet 2023;402:1272–1281.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Tempero MA, Malafa MP, Benson AB, et al. NCCN Clinical Practice Guidelines in Oncology: Pancreatic Adenocarcinoma. Version 1.2024. Accessed April 6, 2024. Available at: https://www.nccn.org

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Bryant KL, Mancias JD, Kimmelman AC, Der CJ. KRAS: feeding pancreatic cancer proliferation. Trends Biochem Sci 2014;39:91–100.

  • 5.

    Arbour KC, Punekar S, Garrido-Laguna I, et al. Preliminary clinical activity of RMC-6236, a first-in-class, RAS-selective, tri-complex RAS-MULTI(ON) inhibitor in patients with KRAS mutant pancreatic ductal adenocarcinoma (PDAC) and non-small cell lung cancer (NSCLC). Ann Oncol 2023;34(Suppl 2):Abstract 652O.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Hu ZI, Shia J, Stadler ZK, et al. Evaluating mismatch repair deficiency in pancreatic adenocarcinoma: challenges and recommendations. Clin Cancer Res 2018;24:1326–1336.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Golan T, Hammel P, Reni M, et al. Maintenance olaparib for germline BRCA-mutated metastatic pancreatic cancer. N Engl J Med 2019;381:317–327.

  • 8.

    Golan T, Hammel P, Reni M, et al. Overall survival from the phase 3 POLO trial: maintenance olaparib for germline BRCA-mutated metastatic pancreatic cancer. J Clin Oncol 2021;39(Suppl 3):Abstract 378.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Hammel P, Huguet F, van Laethem JL, et al. Effect of chemoradiotherapy vs chemotherapy on survival in patients with locally advanced pancreatic cancer controlled after 4 months of gemcitabine with or without erlotinib: the LAP07 randomized clinical trial. JAMA 2016;315:1844–1853.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Fietkau R, Ghadimi M, Grützmann R, et al. Randomized phase III trial of induction chemotherapy followed by chemoradiotherapy or chemotherapy alone for nonresectable locally advanced pancreatic cancer: first results of the CONKO-007 trial. J Clin Oncol 2022;40(Suppl):Abstract 4008.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Katz MHG, Shi Q, Meyers J, et al. Efficacy of preoperative mFOLFIRINOX vs mFOLFIRINOX plus hypofractionated radiotherapy for borderline resectable adenocarcinoma of the pancreas: the A021501 phase 2 randomized clinical trial. JAMA Oncol 2022;8:1263–1270.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Conroy T, Hammel P, Hebbar M, et al. FOLFIRINOX or gemcitabine as adjuvant therapy for pancreatic cancer. N Engl J Med 2018;379:2395–2406.

  • 13.

    Versteijne E, Suker M, Groothuis K, et al. Preoperative chemoradiotherapy versus immediate surgery for resectable and borderline resectable pancreatic cancer: results of the dutch randomized phase III PREOPANC trial. J Clin Oncol 2020;38:1763–1773.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Unno M, Motoi F, Matsuyama Y, et al. Randomized phase II/III trial of neoadjuvant chemotherapy with gemcitabine and S-1 versus upfront surgery for resectable pancreatic cancer (Prep-02/JSAP-05). J Clin Oncol 2019;37(Suppl):Abstract 189.

    • PubMed
    • Search Google Scholar
    • Export Citation
Copyright:
Copyright © 2024 by the National Comprehensive Cancer Network 2024
Article Category:
Abstract
Print Publication Date:
01 May 2024
Online Publication Date:
31 May 2024

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