Metastatic Pancreatic Cancer

Published ahead of print August 5, 2020, DOI:10.1200/JCO.20.01364

Davendra P.S. Sohal, MD, MPH; Erin B. Kennedy, MHSc; Pelin Cinar, MD, MS; Thierry Conroy, MD; Mehmet S. Copur, MD; Christopher H. Crane, MD; Ignacio Garrido-Laguna, MD, PhD; Michelle W. Lau, MD; Tyler Johnson, MD; Smitha Krishnamurthi, MD; Cassadie Moravek, BS; Eileen M. O’Reilly, MD; Philip A. Philip, MD, PhD; Shubham Pant, MD; Manish A. Shah, MD; Vaibhav Sahai, MBBS, MS; Hope E. Uronis, MD, MHS; Neeha Zaidi, MD; and Daniel Laheru, MD

Purpose

The aim of this work was to provide an update to the ASCO guideline on metastatic pancreatic cancer pertaining to recommendations for therapy options after first-line treatment.

Methods

ASCO convened an Expert Panel and conducted a systematic review to update guideline recommendations for second-line therapy for metastatic pancreatic cancer.

Results

One randomized controlled trial of olaparib versus placebo, one report on phase I and II studies of larotrectinib, and one report on phase I and II studies of entrectinib met the inclusion criteria and inform the guideline update.

Recommendations

New or updated recommendations for germline and somatic testing for microsatellite instability high/mismatch repair deficiency, BRCA mutations, and TRK alterations are provided for all treatment-eligible patients to select patients for recommended therapies, including pembrolizumab, olaparib, larotrectinib, or entrectinib, or potential clinical trials. The Expert Panel continues to endorse the remaining recommendations for second-line chemotherapy, as well as other recommendations related to treatment, follow-up, and palliative care from the 2018 version of this guideline.

© 2020 American Society of Clinical Oncology, all rights reserved. For licensing opportunities, contact licensing@asco.org. 

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