Oncology

Metastatic Pancreatic Cancer

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Improving Future Outcomes in Patients with Metastatic Pancreatic Cancer

patient care perspectives by Andrew Hendifar, MD, MPH

Overview

Recent advances in the treatment of pancreatic cancers include new first-line treatments such as FOLFIRINOX and gemcitabine + nab-paclitaxel (Taieb et al 2017). Another advance is the reorganization of multimodal treatment in high patient-volume centers (Gupta et al 2017). Advances such as these have improved overall survival and quality of life, but pancreatic cancer remains a deadly disease (Taieb et al 2017; Gupta et al 2017; Sohal et al 2017). Research remains active and trials are currently ongoing leading to promising new treatments in metastatic pancreatic cancer (Taieb et al 2017; Gupta et al 2017; Sohal et al 2017). In addition, with approximately 10% of all pancreatic cancer cases being recognized as related to familial syndromes, the future of pancreatic cancer treatment and diagnosis may change with the increasing use of genetics (Buanes 2014). The decline in mortality reported in other cancers has not yet been seen in patients with pancreatic cancer (Gupta et al 2017). Further improvement in outcomes in patients with metastatic pancreatic cancer will definitely require additional clinical studies in early diagnosis, prevention, and treatment (Buanes 2014). Such improvement in clinical outcomes is achievable and further progress is expected for patients with metastatic pancreatic cancer (Gupta et al 2017). A member of our expert panel discusses the changing treatment approach in metastatic pancreatic cancer.

Expert Commentary

Andrew Hendifar, MD, MPH

Co-Director, Pancreas Oncology
David Geffen School of Medicine
Cedars Sinai Medical Center
Los Angeles, CA

It is now understood that pancreatic cancer is not really a lifestyle malignancy. It does not happen because of lifestyle choices. It is somehow a function of our modern age, and unfortunately, it is going to become the second most common cause of cancer death in the near future. That being said, our understanding of the disease has grown immensely and our approach is changing rapidly. We are now doing more, whereas in the beginning of my career, we usually opted for doing less. We understand that we still have to do more. We must treat the cancer aggressively with multiagent chemotherapy. We must have multidisciplinary teams that approach the symptoms that these patients have. We have to push the envelope with treatment. We have to enroll patients in clinical trials. We have to come together and really focus on pancreatic cancer. Scientists and clinicians are focusing on this disease more today than in the past. I am very hopeful that we are getting a critical mass together to focus on pancreatic cancer, and that the future is going to be much better for these patients.

"I am very hopeful that we are getting a critical mass together to focus on pancreatic cancer and that the future is going to be much better for these patients."

Andrew Hendifar, MD, MPH

References

Buanes TA. Pancreatic cancer-improved care achievable. World J Gastroenterol. 2014;20(30):10405-18.

Gupta R, Amanam I, Chung V. Current and future therapies for advanced pancreatic cancer. J Surg Oncol. 2017;116(1):25-34.

Sohal DPS, Willingham FF, Falconi M, et al. Pancreatic Adenocarcinoma: Improving Prevention and Survivorship. Am Soc Clin Oncol Educ Book. 2017;37:301-310.

Taieb J, Pointet AL, Van Laethem JL, et al. What treatment in 2017 for inoperable pancreatic cancers? Ann Oncol. 2017 Jul 1;28(7):1473-1483. doi: 10.1093/annonc/mdx174.

Andrew Hendifar, MD, MPH

Co-Director, Pancreas Oncology
David Geffen School of Medicine
Cedars Sinai Medical Center
Los Angeles, CA

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