New Pancreatic Cancer Treatment Guidelines Should Improve Care

Pancreatic cancer is increasingly affecting cancer-related mortality in the United States and is slated to become one of the leading causes of cancer deaths by the end of this decade.

There are no screening programs for early detection. Overall five-year survival is 7.2 percent. Although recent insights into the biology of pancreatic cancer have led to novel therapeutics, and combination regimens have produced incremental improvement in median survival, key clinical issues remain, including:

• The definition of resectable cancer
• Neoadjuvant versus adjuvant therapeutic approaches
• The role of radiation therapy and newer radiation technology
• Appropriate treatment of locally advanced disease
• Sequencing of treatment in metastatic disease

To help address these knowledge gaps, the American Society of Clinical Oncology’s (ASCO) Clinical Practice Guidelines Committee Working Group commissioned expert panels to produce three new pancreatic cancer guideline documents: for potentially curable (likely resectable), locally advanced and metastatic clinical presentations.

“The three published papers represent ASCO and the oncology community’s effort to standardize care of patients with pancreatic cancer in the three most common types of presentation,” says oncologist Alok A. Khorana, MD, Director of Cleveland Clinic Cancer Center’s Gastrointestinal Cancer Program and the co-chair of the panel that prepared the guidelines for potentially curable pancreatic cancer. Oncologist Davendra Sohal, MD, MPH, Director of Cleveland Clinic Cancer Center’s Clinical Genomics Program, co-chaired the panel that produced the metastatic pancreatic cancer guidelines.

“These guidelines have been formulated with consensus from a variety of providers across multiple disciplines and including patient advocates,” Dr. Khorana says. “The manuscripts focus on providing appropriate care across the continuum of care for this illness, with an emphasis on early involvement of palliative care and patient-centered approaches that include treatment decision-making in the context of medical comorbidities. The guidelines also identify the existence of major knowledge gaps and call for additional federal and philanthropic funding to help increase the options available for this difficult illness.”

To read Dr. Khorana’s ASCO Daily News article about the new guidelines, click here.