Update on optimal management for pancreatic cancer: expert perspectives from members of the Australasian Gastrointestinal Trials Group (AGITG) with invited international faculty

Mike Nguyen, Eva Segelov, David Goldstein, Nick Pavlakis, Jeremy Shapiro, Timothy J. Price, Adnan Nagrial, Lorraine Chantrill, Trevor Leong, John Chen, Matt Burge, Christos S. Karapetis, Ian Chau, Florian Lordick, Daniel Renouf, Niall Tebbutt, Amitesh C. Roy

Research output: Contribution to journalReview articlepeer-review

Abstract

Introduction: Pancreatic cancer remains a challenging malignancy due to the high proportion of patients diagnosed at advanced stages and the limited treatment options. This article discusses recent evidence in the management of both localized and advanced pancreatic cancer and offers an expert opinion on current best practice. 

Areas covered: For patients with localized disease, the evidence for adjuvant chemotherapy is discussed as well as emerging neoadjuvant approaches for resectable, borderline resectable, and locally advanced disease. Advances in metastatic disease are discussed including cytotoxic chemotherapy, targeted therapies, and the role of genomic testing to identify patients with molecular alterations. Reviewed literature included journal publications, abstracts presented at major international oncology meetings, and ongoing clinical trials databases. 

Expert opinion: Pancreatic cancer is a devastating diagnosis and despite recent advances has a very poor prognosis. Only a minority of patients, 20%, are diagnosed with potentially curable disease. The shifting paradigm toward neoadjuvant therapy may improve resectability and survival rates; however, robust evidence is required. Thus far, there has only been limited progress in advanced stage disease. Genomic testing may potentially identify more treatment targets although limited to small subgroups.

Original languageEnglish
Pages (from-to)39-51
Number of pages13
JournalExpert Review of Anticancer Therapy
Volume22
Issue number1
Early online date23 Nov 2021
DOIs
Publication statusPublished - 2022

Keywords

  • adjuvant
  • neoadjuvant
  • Pancreatic cancer
  • review
  • survival

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