Choice of first line systemic treatment in pancreatic cancer among national experts
Markus Glatzer, Daniel Horber, Michael Montemurro, Ralf Winterhalder, Roman Inauen, M.D. Berger, Bernhard Pestalozzi, S. Pederiva, Miklos Pless & Paul Martin Putora
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
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 statusand age) and 5 treatment options: FOLFIRINOX, FOLFOX, gemcitabine þ 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 þ nab-paclitaxel. Gemcitabine monotherapy was typically offered to patients in the presence of comorbidities. For patients with ECOG 3e4, most of the experts recommended BSC.
|citation||Glatzer M, Horber D, Montemurro M, Winterhalder R, Inauen R, Berger M, Pestalozzi B, Pederiva S, Pless M, Putora P M. Choice of first line systemic treatment in pancreatic cancer among national experts. Pancreatology 2020; 20 (2020):686-690.|
|type||journal paper/review (English)|
|date of publishing||31-3-2020|
|journal title||Pancreatology (20 (2020))|