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Advanced Pancreatic Adenocarcinoma

MedGen UID:
1686406
•Concept ID:
C5206374
•
Neoplastic Process

Definition

Pancreatic adenocarcinoma that has spread extensively to other anatomic sites or is no longer responding to treatment. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVAdvanced Pancreatic Adenocarcinoma

Professional guidelines

PubMed

Multidisciplinary management of locally advanced pancreatic adenocarcinoma: Biology is King.
Attiyeh MA, Amini A, Chung V, Melstrom LG
J Surg Oncol 2021 May;123(6):1395-1404. doi: 10.1002/jso.26415. PMID: 33831247
Management of unresectable, locally advanced pancreatic adenocarcinoma.
Salgado M, Arévalo S, Hernando O, Martínez A, Yaya R, Hidalgo M
Clin Transl Oncol 2018 Feb;20(2):113-118. Epub 2017 Jun 13 doi: 10.1007/s12094-017-1679-1. PMID: 28612202
Current management and future directions in metastatic pancreatic adenocarcinoma.
Varghese AM, Lowery MA, Yu KH, O'Reilly EM
Cancer 2016 Dec 15;122(24):3765-3775. Epub 2016 Sep 20 doi: 10.1002/cncr.30342. PMID: 27649047Free PMC Article

Recent clinical studies

Etiology

Radiotherapy for Locally Advanced Pancreatic Adenocarcinoma-A Critical Review of Randomised Trials.
Ejlsmark MW, Schytte T, Bernchou U, Bahij R, Weber B, Mortensen MB, Pfeiffer P
Curr Oncol 2023 Jul 18;30(7):6820-6837. doi: 10.3390/curroncol30070499. PMID: 37504359Free PMC Article
Systemic inflammatory prognostic scores in advanced pancreatic adenocarcinoma.
Ma LX, Wang Y, Espin-Garcia O, Allen MJ, Jang GH, Zhang A, Dodd A, Ramotar S, Hutchinson S, Tehfe M, Ramjeesingh R, Biagi J, Wilson JM, Notta F, Fischer SE, Zogopoulos G, Gallinger S, Grant RC, Khokha R, Chan N, Grünwald BT, Knox JJ, O'Kane GM
Br J Cancer 2023 May;128(10):1916-1921. Epub 2023 Mar 16 doi: 10.1038/s41416-023-02214-0. PMID: 36927977Free PMC Article
First-line liposomal irinotecan with oxaliplatin, 5-fluorouracil and leucovorin (NALIRIFOX) in pancreatic ductal adenocarcinoma: A phase I/II study.
Wainberg ZA, Bekaii-Saab T, Boland PM, Dayyani F, Macarulla T, Mody K, Belanger B, Maxwell F, Moore Y, Thiagalingam A, Wang T, Zhang B, Dean A
Eur J Cancer 2021 Jul;151:14-24. Epub 2021 May 4 doi: 10.1016/j.ejca.2021.03.028. PMID: 33957442
Nab-paclitaxel plus gemcitabine versus nab-paclitaxel plus gemcitabine followed by FOLFIRINOX induction chemotherapy in locally advanced pancreatic cancer (NEOLAP-AIO-PAK-0113): a multicentre, randomised, phase 2 trial.
Kunzmann V, Siveke JT, Algül H, Goekkurt E, Siegler G, Martens U, Waldschmidt D, Pelzer U, Fuchs M, Kullmann F, Boeck S, Ettrich TJ, Held S, Keller R, Klein I, Germer CT, Stein H, Friess H, Bahra M, Jakobs R, Hartlapp I, Heinemann V; German Pancreatic Cancer Working Group (AIO-PAK) and NEOLAP investigators
Lancet Gastroenterol Hepatol 2021 Feb;6(2):128-138. Epub 2020 Dec 16 doi: 10.1016/S2468-1253(20)30330-7. PMID: 33338442
Irreversible electroporation of pancreatic adenocarcinoma: a primer for the radiologist.
Rashid MF, Hecht EM, Steinman JA, Kluger MD
Abdom Radiol (NY) 2018 Feb;43(2):457-466. doi: 10.1007/s00261-017-1349-3. PMID: 29051982

Diagnosis

Neo-adjuvant FOLFIRINOX in borderline resectable and locally advanced pancreatic adenocarcinoma.
Temraz S, Nassar F, Hammoud MS, Mukherji D, O'Reilly EM, Dbouk H, Farhat F, Charafeddine M, Faraj W, Khalifeh MJ, Abou-Alfa GK, Shamseddine A
Asia Pac J Clin Oncol 2022 Dec;18(6):735-742. Epub 2022 Mar 31 doi: 10.1111/ajco.13775. PMID: 35362216
First-line liposomal irinotecan with oxaliplatin, 5-fluorouracil and leucovorin (NALIRIFOX) in pancreatic ductal adenocarcinoma: A phase I/II study.
Wainberg ZA, Bekaii-Saab T, Boland PM, Dayyani F, Macarulla T, Mody K, Belanger B, Maxwell F, Moore Y, Thiagalingam A, Wang T, Zhang B, Dean A
Eur J Cancer 2021 Jul;151:14-24. Epub 2021 May 4 doi: 10.1016/j.ejca.2021.03.028. PMID: 33957442
Management of unresectable, locally advanced pancreatic adenocarcinoma.
Salgado M, Arévalo S, Hernando O, Martínez A, Yaya R, Hidalgo M
Clin Transl Oncol 2018 Feb;20(2):113-118. Epub 2017 Jun 13 doi: 10.1007/s12094-017-1679-1. PMID: 28612202
Current management and future directions in metastatic pancreatic adenocarcinoma.
Varghese AM, Lowery MA, Yu KH, O'Reilly EM
Cancer 2016 Dec 15;122(24):3765-3775. Epub 2016 Sep 20 doi: 10.1002/cncr.30342. PMID: 27649047Free PMC Article
Pancreatic cancer.
Brand RE, Tempero MA
Curr Opin Oncol 1998 Jul;10(4):362-6. doi: 10.1097/00001622-199807000-00014. PMID: 9702405

Therapy

Zolbetuximab: First Approval.
Keam SJ
Drugs 2024 Aug;84(8):977-983. Epub 2024 Jul 5 doi: 10.1007/s40265-024-02056-x. PMID: 38967717
Radiotherapy for Locally Advanced Pancreatic Adenocarcinoma-A Critical Review of Randomised Trials.
Ejlsmark MW, Schytte T, Bernchou U, Bahij R, Weber B, Mortensen MB, Pfeiffer P
Curr Oncol 2023 Jul 18;30(7):6820-6837. doi: 10.3390/curroncol30070499. PMID: 37504359Free PMC Article
Systemic inflammatory prognostic scores in advanced pancreatic adenocarcinoma.
Ma LX, Wang Y, Espin-Garcia O, Allen MJ, Jang GH, Zhang A, Dodd A, Ramotar S, Hutchinson S, Tehfe M, Ramjeesingh R, Biagi J, Wilson JM, Notta F, Fischer SE, Zogopoulos G, Gallinger S, Grant RC, Khokha R, Chan N, Grünwald BT, Knox JJ, O'Kane GM
Br J Cancer 2023 May;128(10):1916-1921. Epub 2023 Mar 16 doi: 10.1038/s41416-023-02214-0. PMID: 36927977Free PMC Article
First-line liposomal irinotecan with oxaliplatin, 5-fluorouracil and leucovorin (NALIRIFOX) in pancreatic ductal adenocarcinoma: A phase I/II study.
Wainberg ZA, Bekaii-Saab T, Boland PM, Dayyani F, Macarulla T, Mody K, Belanger B, Maxwell F, Moore Y, Thiagalingam A, Wang T, Zhang B, Dean A
Eur J Cancer 2021 Jul;151:14-24. Epub 2021 May 4 doi: 10.1016/j.ejca.2021.03.028. PMID: 33957442
Nab-paclitaxel plus gemcitabine versus nab-paclitaxel plus gemcitabine followed by FOLFIRINOX induction chemotherapy in locally advanced pancreatic cancer (NEOLAP-AIO-PAK-0113): a multicentre, randomised, phase 2 trial.
Kunzmann V, Siveke JT, Algül H, Goekkurt E, Siegler G, Martens U, Waldschmidt D, Pelzer U, Fuchs M, Kullmann F, Boeck S, Ettrich TJ, Held S, Keller R, Klein I, Germer CT, Stein H, Friess H, Bahra M, Jakobs R, Hartlapp I, Heinemann V; German Pancreatic Cancer Working Group (AIO-PAK) and NEOLAP investigators
Lancet Gastroenterol Hepatol 2021 Feb;6(2):128-138. Epub 2020 Dec 16 doi: 10.1016/S2468-1253(20)30330-7. PMID: 33338442

Prognosis

Systemic inflammatory prognostic scores in advanced pancreatic adenocarcinoma.
Ma LX, Wang Y, Espin-Garcia O, Allen MJ, Jang GH, Zhang A, Dodd A, Ramotar S, Hutchinson S, Tehfe M, Ramjeesingh R, Biagi J, Wilson JM, Notta F, Fischer SE, Zogopoulos G, Gallinger S, Grant RC, Khokha R, Chan N, Grünwald BT, Knox JJ, O'Kane GM
Br J Cancer 2023 May;128(10):1916-1921. Epub 2023 Mar 16 doi: 10.1038/s41416-023-02214-0. PMID: 36927977Free PMC Article
Nab-paclitaxel plus gemcitabine versus nab-paclitaxel plus gemcitabine followed by FOLFIRINOX induction chemotherapy in locally advanced pancreatic cancer (NEOLAP-AIO-PAK-0113): a multicentre, randomised, phase 2 trial.
Kunzmann V, Siveke JT, Algül H, Goekkurt E, Siegler G, Martens U, Waldschmidt D, Pelzer U, Fuchs M, Kullmann F, Boeck S, Ettrich TJ, Held S, Keller R, Klein I, Germer CT, Stein H, Friess H, Bahra M, Jakobs R, Hartlapp I, Heinemann V; German Pancreatic Cancer Working Group (AIO-PAK) and NEOLAP investigators
Lancet Gastroenterol Hepatol 2021 Feb;6(2):128-138. Epub 2020 Dec 16 doi: 10.1016/S2468-1253(20)30330-7. PMID: 33338442
Irreversible electroporation of pancreatic adenocarcinoma: a primer for the radiologist.
Rashid MF, Hecht EM, Steinman JA, Kluger MD
Abdom Radiol (NY) 2018 Feb;43(2):457-466. doi: 10.1007/s00261-017-1349-3. PMID: 29051982
Management of unresectable, locally advanced pancreatic adenocarcinoma.
Salgado M, Arévalo S, Hernando O, Martínez A, Yaya R, Hidalgo M
Clin Transl Oncol 2018 Feb;20(2):113-118. Epub 2017 Jun 13 doi: 10.1007/s12094-017-1679-1. PMID: 28612202
Minimally invasive ablation treatment for locally advanced pancreatic adenocarcinoma.
Rossi M, Orgera G, Hatzidakis A, Krokidis M
Cardiovasc Intervent Radiol 2014 Jun;37(3):586-91. Epub 2013 Aug 30 doi: 10.1007/s00270-013-0724-x. PMID: 23989503

Clinical prediction guides

Combination of pembrolizumab and pelareorep promotes anti-tumour immunity in advanced pancreatic adenocarcinoma (PDAC).
Mahalingam D, Chen S, Xie P, Loghmani H, Heineman T, Kalyan A, Kircher S, Helenowski IB, Mi X, Maurer V, Coffey M, Mulcahy M, Benson A, Zhang B
Br J Cancer 2023 Sep;129(5):782-790. Epub 2023 Jul 13 doi: 10.1038/s41416-023-02344-5. PMID: 37443348Free PMC Article
Systemic inflammatory prognostic scores in advanced pancreatic adenocarcinoma.
Ma LX, Wang Y, Espin-Garcia O, Allen MJ, Jang GH, Zhang A, Dodd A, Ramotar S, Hutchinson S, Tehfe M, Ramjeesingh R, Biagi J, Wilson JM, Notta F, Fischer SE, Zogopoulos G, Gallinger S, Grant RC, Khokha R, Chan N, Grünwald BT, Knox JJ, O'Kane GM
Br J Cancer 2023 May;128(10):1916-1921. Epub 2023 Mar 16 doi: 10.1038/s41416-023-02214-0. PMID: 36927977Free PMC Article
Neo-adjuvant FOLFIRINOX in borderline resectable and locally advanced pancreatic adenocarcinoma.
Temraz S, Nassar F, Hammoud MS, Mukherji D, O'Reilly EM, Dbouk H, Farhat F, Charafeddine M, Faraj W, Khalifeh MJ, Abou-Alfa GK, Shamseddine A
Asia Pac J Clin Oncol 2022 Dec;18(6):735-742. Epub 2022 Mar 31 doi: 10.1111/ajco.13775. PMID: 35362216
Antibiotic use influences outcomes in advanced pancreatic adenocarcinoma patients.
Mohindroo C, Hasanov M, Rogers JE, Dong W, Prakash LR, Baydogan S, Mizrahi JD, Overman MJ, Varadhachary GR, Wolff RA, Javle MM, Fogelman DR, Lotze MT, Kim MP, Katz MHG, Pant S, Tzeng CD, McAllister F
Cancer Med 2021 Aug;10(15):5041-5050. Epub 2021 Jul 11 doi: 10.1002/cam4.3870. PMID: 34250759Free PMC Article
First-line liposomal irinotecan with oxaliplatin, 5-fluorouracil and leucovorin (NALIRIFOX) in pancreatic ductal adenocarcinoma: A phase I/II study.
Wainberg ZA, Bekaii-Saab T, Boland PM, Dayyani F, Macarulla T, Mody K, Belanger B, Maxwell F, Moore Y, Thiagalingam A, Wang T, Zhang B, Dean A
Eur J Cancer 2021 Jul;151:14-24. Epub 2021 May 4 doi: 10.1016/j.ejca.2021.03.028. PMID: 33957442

Recent systematic reviews

The Impact of Pancreatic Enzyme Replacement Therapy on Patients With Advanced Pancreatic Adenocarcinoma: A Systematic Review and Narrative Synthesis.
Landers A, Donaldson F, Brown H, McKenzie C, Pendharkar S
Pancreas 2022 May 1;51(5):405-414. doi: 10.1097/MPA.0000000000002049. PMID: 35973015
Role of stereotactic body radiation in the enhancement of the quality of life in locally advanced pancreatic adenocarcinoma: a systematic review.
Vornhülz M, Anton S, Eross B, Szakács Z, Hegyi P, Regel I, Belka C, Niyazi M, Mayerle J, Beyer G
Radiat Oncol 2022 Jun 17;17(1):108. doi: 10.1186/s13014-022-02076-5. PMID: 35715808Free PMC Article
Multimodal therapy with or without irreversible electroporation for unresectable locally advanced pancreatic adenocarcinoma: a systematic review and meta-analysis.
Sugumar K, Hurtado A, Naik I, Hue JJ, Rothermel LD, Ammori JB, Hardacre JM, Winter JM, Ocuin LM
HPB (Oxford) 2022 May;24(5):586-595. Epub 2021 Dec 24 doi: 10.1016/j.hpb.2021.12.014. PMID: 35000842
The impact of metastatic sites in advanced pancreatic adenocarcinoma, systematic review and meta-analysis of prospective randomized studies.
Usón PLS Junior, Tolentino FDS, Santos VM, Rother ET, Maluf FC
PLoS One 2020;15(3):e0230060. Epub 2020 Mar 4 doi: 10.1371/journal.pone.0230060. PMID: 32130264Free PMC Article
Preclinical Rationale for the Phase III Trials in Metastatic Pancreatic Cancer: Is Wishful Thinking Clouding Successful Drug Development for Pancreatic Cancer?
Thota R, Maitra A, Berlin JD
Pancreas 2017 Feb;46(2):143-150. doi: 10.1097/MPA.0000000000000753. PMID: 28085753Free PMC Article

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