Gastroenterology Search
Gastroenterology Gastroenterology
pancreatic%20cancer
PANCREATIC CANCER
Treatment Guideline Chart
Pancreatic cancer is malignancy arising from the pancreas.
It is the 13th most common cancer in the world, 10th most common in the United States, and 4th leading cause of cancer-related deaths in the United Stated and Europe.
Exocrine tumors account for 95% of malignant pancreatic disease.
It is more common in women.
The median age of occurrence is at 71 years old.

Pancreatic Cancer References

  1. Cartwright TH, Cohn A, Varkey JA, et al. Phase II study of oral capecitabine in patients with advanced or metastatic pancreatic cancer. J Clin Oncol. 2002 Jan;20(1):160-164. PMID: 11773165
  2. Cascinu S, Jelic S; ESMO Guidelines Working Group. Pancreatic cancer: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol. 2009 Jan;20(1):160-164. http://annonc.oxfordjournals.org. PMID: 19454458
  3. Cascinu S, Falconi M, Valentini V, Jelic S; ESMO Guidelines Working Group. Pancreatic cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2010 May;21(Suppl 5):v55-58. http://annonc.oxfordjournals.org. PMID: 20555103
  4. Cunningham D, Chau I, Stocken DD, et al. Phase III randomized comparison of gemcitabine versus gemcitabine plus capecitabine in patients with advanced pancreatic cancer. J Clin Oncol. 2009 Nov;27(33):5513-5518. http://jco.ascopubs.org. PMID: 19858379
  5. Dragovich T. Pancreatic cancer treatment protocols. eMedicine. http://emedicine.medscape.com.
  6. Fine RL, Fogelman DR, Schreibman SM, Desai M, et al. The gemcitabine, docetaxel, and capecitabine (GTX) regimen for metastatic pancreatic cancer: a retrospective analysis. Cancer Chemother Pharmacol. 2008 Jan;61(1):167-175. PMID: 17440727
  7. Hameed M, Hameed H, Erdek M. Pain management in pancreatic cancer. Cancers. 2011 Dec;3:43-60. http://www.ncbi.nlm.nih.gov. PMID: 24212605
  8. Kim YJ, Lee WJ, Woo SM, Kim TH, et al. Comparison of capecitabine and 5-fluorouracil in chemoradiotherapy for locally advanced pancreatic cancer. Radiat Oncol. 2013 Jul;8(1):160. http://www.ncbi.nlm.nih.gov. PMID: 23822606
  9. Kulke MH, Blaszkowsky LS, Ryan DP, Clark JW, et al. Capecitabine plus erlotinib in gemcitabine-refractory advanced pancreatic cancer. J Clin Oncol. 2007 Oct;25(30):4787-4792. http://jco.ascopubs.org. PMID: 17947726
  10. Mauro LA, Herman JM, Jaffee EM, Laheru DA. Carcinoma of the pancreas. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Inc; 2014.
  11. National Cancer Institute. Pancreatic cancer treatment. National Cancer Institute. http://www.cancer.gov. Jun 2013.
  12. National Comprehensive Cancer Network Pancreatic Adenocarcinoma Panel. NCCN Clinical practice guidelines in oncology (NCCN Guidelines): Pancreatic adenocarcinoma. Version 1.2013. National Comprehensive Cancer Network. http://www.nccn.org/. 2013. Accessed 06 Jan 2014.
  13. Ryan DP, Mamon H. Initial chemotherapy and radiation for nonmetastatic locally advanced unresectable, borderline resectable, and potentially resectable exocrine pancreatic cancer. UpToDate. http://www.uptodate.com. May 2014.
  14. Seufferlein T, Bachet JB, Van Cutsem E, Rougier P; ESMO Guidelines Working Group. Pancreatic adenocarcinoma: ESMO-ESDO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2012 Oct;23(7):vii33-40. http://annonc.oxfordjournals.org. PMID: 22997452
  15. World Cancer Research Fund. Cancer statistics: Data on specific cancers. Pancreatic cancer. World Cancer Research Fund. http://www.wcrf.org.
  16. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: pancreatic adenocarcinoma version 1.2015. NCCN web site. http://www.nccn.org. 04 Dec 2014.
  17. Ducreux M, Cuhna AS, Caramella C, et al; ESMO Guidelines Committee. Cancer of the pancreas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2015 Sep;26(Suppl 5):v56-68. doi: 10.1093/annonc/mdv295. PMID: 26314780
  18. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: pancreatic adenocarcinoma version 2.2015. NCCN. http://www.nccn.org. 06 Mar 2015. Accessed 24 Nov 2015.
  19. The Singapore Cancer Network (SCAN) Pancreatic Cancer Workgroup. Singapore Cancer Network (SCAN) guidelines for systemic therapy of pancreatic adenocarcinoma. Ann Acad Med Singapore. 2015 Oct 10;44(10):388-396. http://www.annals.edu.sg. Accessed 24 Nov 2015
  20. Oettle H. Progress in the knowledge and treatment of advanced pancreatic cancer: from benchside to bedside. Cancer Treat Rev. 2014 Oct;40(9):1039-1047. doi: 10.1016/j.ctrv.2014.07.003. PMID: 25087471
  21. Ryan DP. Chemotherapy for advanced exocrine pancreatic cancer. UptoDate Web Site. http://www.uptodate.com. Jan 2016. Accessed 15 Mar 2016.
  22. American Cancer Society. Pancreatic cancer: causes, risk factors, and prevention. American Cancer Society. https://www.cancer.org/. 11 Feb 2019.
  23. American Cancer Society. Pancreatic cancer stages. American Cancer Society. https://www.cancer.org/. 18 Dec 2017.
  24. Asbun HJ, Moekotte AL, Vissers FL, et al. The Miami international evidence-based guidelines on minimally invasive pancreas resection. Ann Surg. 2020 Jan;271(1):1-14. doi: 10.1097/SLA.0000000000003590. PMID: 31567509
  25. Balaban EP, Mangu PB, Khorana AA, et al. Locally advanced, unresectable pancreatic cancer: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2016 Aug;34(22):2654-2668. doi: 10.1200/JCO.2016.67.5561. PMID: 27247216
  26. Cancer Council Australia. Optimal care pathway for people with pancreatic cancer. Cancer Council Australia. https://www.cancer.org.au/. Feb 2020.
  27. Cancer Therapy Advisor. Pancreatic adenocarcinoma treatment regimens. Cancer Therapy Advisor. https://www.cancertherapyadvisor.com/. 06 Mar 2020.
  28. ESMO Guidelines Committee. eUpdate – cancer of the pancreas treatment recommendations. ESMO. http://www.esmo.org/. 20 Jun 2017.
  29. ESMO Guidelines Committee. eUpdate – cancer of the pancreas treatment recommendations. ESMO. http://www.esmo.org/. 15 Mar 2019.
  30. Goggins M, Overbeek KA, Brand R, et al. Management of patients with increased risk of familial pancreatic cancer: updated recommendations from the International Cancer of the Pancreas Screening (CAPS) Consortium. Gut. 2020 Jan;69(1):7-17. doi: 10.1136/gutjnl-2019-319352. PMID: 31672839
  31. Khorana AA, McKernin SE, Berlin J, et al. Potentially curable pancreatic adenocarcinoma: ASCO clinical practice guideline update. J Clin Oncol. 2019 Aug;37(23):2082-2088. doi: 10.1200/JCO.19.00946. PMID: 31180816
  32. Lambert A, Schwarz L, Borbath I, et al. An update on treatment options for pancreatic adenocarcinoma. Ther Adv Med Oncol. 2019;11:1758835919875568. doi: 10.1177/175883591987556. PMID: 31598142
  33. Loveday BPT, Lipton L, Thomson BNJ. Pancreatic cancer: an update on diagnosis and management. AJGP. 2019 Dec;48(12):B26-B31. doi: 10.31128/AJGP-06-19-4957.
  34. Matsubayashi H, Takaori K, Morizane C, et al. Familial pancreatic cancer and surveillance of high-risk individuals. Gut and Liver. 2019 Sep;13(5):498-505. doi: 10.5009/gnl18449. PMID: 30917631
  35. National Cancer Institute. Pancreatic cancer treatment (PDQ®) - health professional version. National Cancer Institute. http: https://www.cancer.gov/. 14 Feb 2020.
  36. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Genetic/familial high-risk assessment: breast, ovarian, and pancreatic. Version 1.2020. NCCN. https://www.nccn.org/. 04 Dec 2019.
  37. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Pancreatic adenocarcinoma. Version 1.2020. NCCN. https://www.nccn.org/. 26 Nov 2019.
  38. National Institute for Health and Care Excellence (NICE). Pancreatic cancer in adults: diagnosis and management. NICE. https://www.nice.org.uk/. 07 Feb 2018.
  39. Okusaka T, Furuse J. Recent advances in chemotherapy for pancreatic cancer: evidence from Japan and recommendations in guidelines. J Gastroenterol. 2020 Apr;55(4):369-382. doi: 10.1007/s00535-020-01666-y. PMID: 31997007
  40. Palta M, Godfrey D, Goodman KA, et al. Radiation therapy for pancreatic cancer: executive summary of an ASTRO clinical practice guideline. Pract Radial Oncol. 2019 Sep;9(5):322-332. doi: 10.1016/j.prro.2019.06.016. PMID: 31474330
  41. Sohal DPS, Kennedy EB, Khorana A, et al. Metastatic pancreatic cancer: ASCO clinical practice guideline update. J Clin Oncol. 2018 Aug;36(24):2545-2556. doi: 10.1200/JCO.2018.78.9636. PMID: 29791286
  42. Aslanian HR, Lee JH, Canto MI. AGA clinical practice update on pancreas cancer screening in high-risk individuals: expert review. Gastroenterology. 2020 Jul;159(1):358-362. doi: 10.1053/j.gastro.2020.03.088. PMID: 32416142
  43. Fernandez-del Castillo C. Clinical manifestations, diagnosis, and staging of exocrine pancreatic cancer. UpToDate. https://www.uptodate.com. 17 Feb 2021.
  44. Grossberg AJ, Chu LC, Deig CR, et al. Multidisciplinary standards of care and recent progress in pancreatic ductal adenocarcinoma. CA Cancer J Clin. 2020 Oct;70(5):375-403. doi: 10.3322/caac.21626. PMID: 32683683
  45. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology: Genetic/familial high-risk assessment: breast, ovarian, and pancreatic. Version 2.2021. NCCN. https://www.nccn.org/. 20 Nov 2020.
  46. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology: Pancreatic adenocarcinoma. Version 2.2021. NCCN. https://www.nccn.org/. 25 Feb 2021.
  47. PDQ® Adult Treatment Editorial Board. PDQ pancreatic cancer treatment (adult). Bethesda, MD: National Cancer Institute; 2021 Feb. https://www.cancer.gov/.
  48. Sohal DPS, Kennedy EB, Cinar P, et al. Metastatic pancreatic cancer: ASCO guideline update. J Clin Oncol. 2020 Aug;38(27):3217-3230. doi: 10.1200/JCO.20.01364. PMID: 32755482
  49. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology (NCCN guidelines®): Genetic/familial high-risk assessment: breast, ovarian, and pancreatic. Version 2.2022. NCCN. https://www.nccn.org/. 09 Mar 2022.
  50. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology (NCCN guidelines®): Pancreatic adenocarcinoma. Version 1.2022. NCCN. https://www.nccn.org/. 24 Feb 2022.
  51. Ryan DP. Initial systemic chemotherapy for metastatic exocrine pancreatic cancer. UpToDate. https://www.uptodate.com/. 11 Aug 2022. Accessed 11 Aug 2022.
  52. Ryan DP. Second-line systemic therapy for advanced exocrine pancreatic cancer. UpToDate. https://www.uptodate.com/. 21 Jul 2022.
  53. Sawhney MS, Calderwood AH, Thosani NC, et al. ASGE guideline on screening for pancreatic cancer in individuals with genetic susceptibility: summary and recommendations. Gastrointest Endosc. 2022 May;95(5):817-826. doi: 10.1016/j.gie.2021.12.001. PMID: 35183358
  54. DeVita VT, Lawrence TS, Rosenberg SA. Devita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia: Wolters Kluwer; 2019.
Editor's Recommendations
Special Reports
MORE Special Reports arrow
Related Disease News
MORE Disease News arrow