Choice of first line systemic treatment in pancreatic cancer among national experts.

Glatzer, Markus; Horber, D.; Montemurro, M.; Winterhalder, R.; Inauen, R.; Berger, M. D.; Pestalozzi, B.; Pederiva, S.; Pless, M.; Putora, P. M. (2020). Choice of first line systemic treatment in pancreatic cancer among national experts. Pancreatology, 20(4), pp. 686-690. Elsevier 10.1016/j.pan.2020.03.012

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BACKGROUND

Treatment options for patients with metastatic pancreatic cancer depend on various factors, including performance status, tumor burden and patient preferences. Metastatic pancreatic cancer is incurable and many systemic treatment options have been investigated over the past decades. This analysis of patterns of practice was performed to identify decision criteria and their impact on the choice of first-line management of metastatic pancreatic cancer.

MATERIALS AND METHODS

Members of the Swiss Group for Clinical Cancer Research (SAKK) Gastrointestinal Cancer Group were contacted and agreed to participate in this analysis. Decision trees for the first line treatment of metastatic pancreatic cancer from 9 centers in Switzerland were collected and analyzed based on the objective consensus methodology to identify consensus and discrepancies in clinical decision-making.

RESULTS

The final treatment algorithms included 3 decision criteria (comorbidities, performance status and age) and 5 treatment options: FOLFIRINOX, FOLFOX, gemcitabine + nab-paclitaxel, gemcitabine mono and best supportive care.

CONCLUSION

We identified multiple decision criteria relevant to all participating centers. We found consensus for the treatment of young (age below 65) patients with good performance status with FOLFIRINOX. For patients with increasing age and reducing performance status there was a decreasing trend to use gemcitabine + nab-paclitaxel. Gemcitabine monotherapy was typically offered to patients in the presence of comorbidities. For patients with ECOG 3-4, most of the experts recommended BSC.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

UniBE Contributor:

Glatzer, Markus; Berger, Martin Dave and Putora, Paul Martin

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1424-3903

Publisher:

Elsevier

Language:

English

Submitter:

Rebeka Gerber

Date Deposited:

12 Aug 2020 12:20

Last Modified:

29 Oct 2020 08:41

Publisher DOI:

10.1016/j.pan.2020.03.012

PubMed ID:

32299764

Uncontrolled Keywords:

Decision criteria FOLFIRINOX Nab-paclitaxel Pancreatic cancer Treatment algorithm decision-making

BORIS DOI:

10.7892/boris.145785

URI:

https://boris.unibe.ch/id/eprint/145785

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