Medical Oncology

Pancreatic Cancer

Questions discussed in this category

What systemic therapy and dose adjustments would you implement for patients with pancreas cancer and cirrhosis with pancytopenia?

The patient declined palliative measures only and is motivated to receive treatment

4 Answers available

How would you manage a borderline resectable pancreatic cancer s/p induction chemo + chemo-RT who was unable to go to surgery?

Specifically, after chemo and RT to 36.0 Gy/15 fx with stable to slight progression of disease at 6 months, what (if any) regimen of reirradiation wou...

2 Answers available

When a patient with pancreatic cancer received neoadjuvant chemo + chemo-RT, how do you manage an in-field, post operative positive margin?

I.e. would you offer additional radiotherapy and if so, what technique and dose would you use?

3 Answers available

Do you always biopsy suspicious liver lesions if you have a biopsy from the pancreatic mass showing PDAC?

Or do you start with systemic therapy and then reassess?

3 Answers available

What is the role of adjuvant radiation in R0 node positive resected pancreatic adenocarcinoma in light of the recently presented RTOG 0848 abstract?

RTOG 0848 presented at ASCO 2024 in abstract form: Abrams et al., Journal of Clinical Oncology 2024 What pathologic factors if any would you use to m...

4 Answers available

What are your top takeaways from ASCO GI 2023?

What were your “top 3” presentations/studies coming out of the meeting this year and how will it impact your own clinical practice? ...

8 Answers available

How would you treat an elderly patient with biopsy proven extensive non-resectable metastatic pseudopapillary pancreatic tumor?

1 Answer available

Would you offer consolidative full dose chemo-RT for local residual pancreatic disease in a patient with stage IV pancreatic adenocarcinoma with excellent response after induction chemotherapy?

Would you ever consider this approach for an initially polymetastatic patient?

2 Answers available

How long should surgery be delayed in a patient with localized, resectable pancreatic cancer who developed acute pancreatitis following EUS guided biopsy?

And if delayed, should chemotherapy be started?

2 Answers available

Should immunotherapy be added to standard of care neoadjuvant chemotherapy in borderline resectable MSI-H adenocarcinoma of pancreas?

Is there data to support this approach?

2 Answers available

How would you approach a locally advanced ampullary carcinoma with BRCA1 mutation whose Whipple showed complete pathologic response after 5 cycles of neoadjuvant mFOLFIRINOX?

Patient refuses further mFOLFIRINOX but may be open to less aggressive regimens. Is there any role for PARP inhibitors?

1 Answer available

Would you favor starting with pembrolizumab or chemotherapy for a metastatic MSI-high pancreatic ductal adenocarcinoma?

Would your recommendation change in a patient having pain from disease and you wanted a quick response?

1 Answer available

Would you recommend adjuvant chemotherapy for a patient with subcentimeter pancreatic adenocarcinoma incidentally found during a Whipple resection for high risk IPMN?

1 Answer available

What is your preferred first line regimen for a patient with BRCA+ metastatic pancreatic cancer with poor performance status?

2 Answers available

What third line treatment do you consider for a patient with metastatic pancreatic cancer with good functional status and no targetable mutations after progression on FOLFIRINOX and gemcitabine/nab-paclitaxel?

3 Answers available

Papers discussed in this category

N. Engl. J. Med., 2019 Jun 02

Maintenance Olaparib for Germline -Mutated Metastatic Pancreatic Cancer.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2015-01-20

Olaparib monotherapy in patients with advanced cancer and a germline BRCA1/2 mutation.

Pancreatology, 2020 Oct 18

Nanoliposomal irinotecan (Nal-IRI)-based chemotherapy after irinotecan -based chemotherapy in patients with pancreas cancer.

Lancet (London, England), 2016-02-06

Nanoliposomal irinotecan with fluorouracil and folinic acid in metastatic pancreatic cancer after previous gemcitabine-based therapy (NAPOLI-1): a global, randomised, open-label, phase 3 trial.

European journal of cancer (Oxford, England : 1990), 2019-02

NAPOLI-1 phase 3 study of liposomal irinotecan in metastatic pancreatic cancer: Final overall survival analysis and characteristics of long-term survivors.

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2007-11

Prognostic significance of pathologic nodal status in patients with resected pancreatic cancer.

Annals of surgery, 2010-03

Histopathologic basis for the favorable survival after resection of intraductal papillary mucinous neoplasm-associated invasive adenocarcinoma of the pancreas.

Cancer, 2016-02-15

The efficacy of adjuvant therapy for pancreatic invasive intraductal papillary mucinous neoplasm (IPMN).

Cancer, 2019-01-01

Role of adjuvant therapy in resected stage IA subcentimeter (T1a/T1b) pancreatic cancer.

HPB : the official journal of the International Hepato Pancreato Biliary Association, 2017-07

Does adjuvant therapy improve overall survival for stage IA/B pancreatic adenocarcinoma?

N. Engl. J. Med.,

FOLFIRINOX or Gemcitabine as Adjuvant Therapy for Pancreatic Cancer.

The New England journal of medicine, 2013-10-31

Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine.

Lancet, 2021 Jun 05

First-line nivolumab plus chemotherapy versus chemotherapy alone for advanced gastric, gastro-oesophageal junction, and oesophageal adenocarcinoma (CheckMate 649): a randomised, open-label, phase 3 trial.

Eur J Cancer, 2018 Aug 24

A randomised phase 2 trial of nab-paclitaxel plus gemcitabine with or without capecitabine and cisplatin in locally advanced or borderline resectable pancreatic adenocarcinoma.

NEJM Evidence, 2022 Jun 1

Durvalumab plus Gemcitabine and Cisplatin in Advanced Biliary Tract Cancer

J Clin Oncol, 2019 Nov 04

Efficacy of Pembrolizumab in Patients With Noncolorectal High Microsatellite Instability/Mismatch Repair-Deficient Cancer: Results From the Phase II KEYNOTE-158 Study.

Gut, 2020 Apr 29

Comprehensive characterisation of pancreatic ductal adenocarcinoma with microsatellite instability: histology, molecular pathology and clinical implications.

American journal of clinical oncology, 2023 Dec 22

Executive Summary of the American Radium Society Appropriate Use Criteria for Neoadjuvant Therapy for Nonmetastatic Pancreatic Adenocarcinoma: Systematic Review and Guidelines.

Int J Radiat Oncol Biol Phys, 2022 Jul 04

A Critical Review of the Role of Local Therapy for Oligometastatic Gastrointestinal Cancer.

Lancet (London, England), 2023 Dec 14

Standard-of-care systemic therapy with or without stereotactic body radiotherapy in patients with oligoprogressive breast cancer or non-small-cell lung cancer (Consolidative Use of Radiotherapy to Block [CURB] oligoprogression): an open-label, randomised, controlled, phase 2 study.

International journal of radiation oncology, biology, physics, 2011-12-01

The influence of total nodes examined, number of positive nodes, and lymph node ratio on survival after surgical resection and adjuvant chemoradiation for pancreatic cancer: a secondary analysis of RTOG 9704.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2009-04-10

DPC4 gene status of the primary carcinoma correlates with patterns of failure in patients with pancreatic cancer.

JAMA Oncol,

Association of Ablative Radiation Therapy With Survival Among Patients With Inoperable Pancreatic Cancer.

Annals of surgical oncology, 2022 Jan 05

Landmark Series: Importance of Pancreatic Resection Margins.

Practical radiation oncology, 2022 Feb 07

Location, Location, Location: What Should be Targeted Beyond Gross Disease for Localized Pancreatic Ductal Adenocarcinoma? Proposal of a Standardized Clinical Tumor Volume for Pancreatic Ductal Adenocarcinoma of the Head: The "Triangle Volume".

Journal of gastrointestinal oncology, 2021 Oct

Pathology reporting of margin status in locally advanced pancreatic cancer: challenges and uncertainties.

Annals of surgery, 2024 Jul 23

Impact of Positive Resection Margins on Recurrence and Survival Following Resection and Adjuvant Chemotherapy in Pancreatic Cancer: Results of the PRODIGE 24-CCTG PA-6 Randomized Controlled Trial.

Journal of clinical medicine, 2024 Apr 30

Salvage Ablative Radiotherapy for Isolated Local Recurrence of Pancreatic Adenocarcinoma following Definitive Surgery.

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