Key Points
➤ There will be an estimated 57,600 new cases and 47,050 deaths as a
result of pancreatic cancer in the United States in 2020. There were an
estimated 460,000 new cases worldwide in 2018.
➤ A diagnosis of pancreatic ductal adenocarcinoma is associated with poor
prognosis due to early micrometastatic spread.
➤ The 5-year survival rate for metastatic pancreatic cancer is approximately
2.9%.
➤ This 2020 update of the 2018 recommendations was triggered by:
• New evidence for PARP inhibitor olaparib as an option for maintenance therapy after
first-line treatment and
• New studies of tissue agnostic agents that target fusions of the neurotrophin tyrosine
receptor kinase (NTRK) 1/2/3 genes.
Diagnosis
* Note: Unbold text is a new or updated 2020 recommendation.
Initial Assessment
Recommendation 1.1
➤ A multiphase computed tomography scan of the chest, abdomen, and
pelvis should be performed to assess extent of disease. Other staging
studies should be performed only as dictated by symptoms (Strong
recommendation; EB-B-I).
Recommendation 1.2
➤ The baseline PS, symptom burden, and comorbidity profile of a patient
with metastatic pancreatic cancer should be evaluated carefully (Strong
recommendation; EB-B-I).
Recommendation 1.3
➤ The goals of care (to include a discussion of an advance directive), patient
preferences, as well as support systems should be discussed with every
patient with metastatic pancreatic cancer and his or her caregivers
(Strong recommendation; EB-B-I).
