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Locally Advanced Unresectable Pancreatic Adenocarcinoma

MedGen UID:
1668759
•Concept ID:
C4744358
•
Neoplastic Process

Definition

A pancreatic adenocarcinoma that has spread from its original site of growth to nearby tissues or lymph nodes and is not amenable to surgical resection. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVLocally Advanced Unresectable Pancreatic Adenocarcinoma

Professional guidelines

PubMed

Real-world outcomes of cisplatin, capecitabine, and gemcitabine with either epirubicin (PEXG) or docetaxel (PDXG) as first-line palliative treatment in metastatic or unresectable locally advanced pancreatic adenocarcinoma.
Hitchen N, Waldron NR, Deva S, Findlay M, Lawrence B
Asia Pac J Clin Oncol 2023 Oct;19(5):e231-e238. Epub 2022 Sep 16 doi: 10.1111/ajco.13845. PMID: 36114593
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
Percutaneous Image-Guided Irreversible Electroporation for the Treatment of Unresectable, Locally Advanced Pancreatic Adenocarcinoma.
Narayanan G, Hosein PJ, Beulaygue IC, Froud T, Scheffer HJ, Venkat SR, Echenique AM, Hevert EC, Livingstone AS, Rocha-Lima CM, Merchan JR, Levi JU, Yrizarry JM, Lencioni R
J Vasc Interv Radiol 2017 Mar;28(3):342-348. Epub 2016 Dec 16 doi: 10.1016/j.jvir.2016.10.023. PMID: 27993507

Recent clinical studies

Etiology

Cholangiocarcinoma landscape in Europe: Diagnostic, prognostic and therapeutic insights from the ENSCCA Registry.
Izquierdo-Sanchez L, Lamarca A, La Casta A, Buettner S, Utpatel K, Klümpen HJ, Adeva J, Vogel A, Lleo A, Fabris L, Ponz-Sarvise M, Brustia R, Cardinale V, Braconi C, Vidili G, Jamieson NB, Macias RI, Jonas JP, Marzioni M, Hołówko W, Folseraas T, Kupčinskas J, Sparchez Z, Krawczyk M, Krupa Ł, Scripcariu V, Grazi GL, Landa-Magdalena A, Ijzermans JN, Evert K, Erdmann JI, López-López F, Saborowski A, Scheiter A, Santos-Laso A, Carpino G, Andersen JB, Marin JJ, Alvaro D, Bujanda L, Forner A, Valle JW, Koerkamp BG, Banales JM
J Hepatol 2022 May;76(5):1109-1121. Epub 2022 Feb 12 doi: 10.1016/j.jhep.2021.12.010. PMID: 35167909
Multidisciplinary standards of care and recent progress in pancreatic ductal adenocarcinoma.
Grossberg AJ, Chu LC, Deig CR, Fishman EK, Hwang WL, Maitra A, Marks DL, Mehta A, Nabavizadeh N, Simeone DM, Weekes CD, Thomas CR Jr
CA Cancer J Clin 2020 Sep;70(5):375-403. Epub 2020 Jul 19 doi: 10.3322/caac.21626. PMID: 32683683Free PMC Article
Pancreatic cancer: An update on diagnosis and management.
Loveday BPT, Lipton L, Thomson BN
Aust J Gen Pract 2019 Dec;48(12):826-831. doi: 10.31128/AJGP-06-19-4957. PMID: 31774983
Total Neoadjuvant Therapy With FOLFIRINOX in Combination With Losartan Followed by Chemoradiotherapy for Locally Advanced Pancreatic Cancer: A Phase 2 Clinical Trial.
Murphy JE, Wo JY, Ryan DP, Clark JW, Jiang W, Yeap BY, Drapek LC, Ly L, Baglini CV, Blaszkowsky LS, Ferrone CR, Parikh AR, Weekes CD, Nipp RD, Kwak EL, Allen JN, Corcoran RB, Ting DT, Faris JE, Zhu AX, Goyal L, Berger DL, Qadan M, Lillemoe KD, Talele N, Jain RK, DeLaney TF, Duda DG, Boucher Y, Fernández-Del Castillo C, Hong TS
JAMA Oncol 2019 Jul 1;5(7):1020-1027. doi: 10.1001/jamaoncol.2019.0892. PMID: 31145418Free PMC Article
Pancreatic cancer.
Vincent A, Herman J, Schulick R, Hruban RH, Goggins M
Lancet 2011 Aug 13;378(9791):607-20. Epub 2011 May 26 doi: 10.1016/S0140-6736(10)62307-0. PMID: 21620466Free PMC Article

Diagnosis

Pancreatic Cancer: A Review.
Park W, Chawla A, O'Reilly EM
JAMA 2021 Sep 7;326(9):851-862. doi: 10.1001/jama.2021.13027. PMID: 34547082Free PMC Article
Multidisciplinary standards of care and recent progress in pancreatic ductal adenocarcinoma.
Grossberg AJ, Chu LC, Deig CR, Fishman EK, Hwang WL, Maitra A, Marks DL, Mehta A, Nabavizadeh N, Simeone DM, Weekes CD, Thomas CR Jr
CA Cancer J Clin 2020 Sep;70(5):375-403. Epub 2020 Jul 19 doi: 10.3322/caac.21626. PMID: 32683683Free PMC Article
Pancreatic cancer: An update on diagnosis and management.
Loveday BPT, Lipton L, Thomson BN
Aust J Gen Pract 2019 Dec;48(12):826-831. doi: 10.31128/AJGP-06-19-4957. PMID: 31774983
Ablative radiation therapy for locally advanced pancreatic cancer: techniques and results.
Reyngold M, Parikh P, Crane CH
Radiat Oncol 2019 Jun 6;14(1):95. doi: 10.1186/s13014-019-1309-x. PMID: 31171025Free PMC Article
Pancreatic cancer.
Vincent A, Herman J, Schulick R, Hruban RH, Goggins M
Lancet 2011 Aug 13;378(9791):607-20. Epub 2011 May 26 doi: 10.1016/S0140-6736(10)62307-0. PMID: 21620466Free PMC Article

Therapy

Pancreatic Cancer: A Review.
Park W, Chawla A, O'Reilly EM
JAMA 2021 Sep 7;326(9):851-862. doi: 10.1001/jama.2021.13027. PMID: 34547082Free PMC Article
Multidisciplinary standards of care and recent progress in pancreatic ductal adenocarcinoma.
Grossberg AJ, Chu LC, Deig CR, Fishman EK, Hwang WL, Maitra A, Marks DL, Mehta A, Nabavizadeh N, Simeone DM, Weekes CD, Thomas CR Jr
CA Cancer J Clin 2020 Sep;70(5):375-403. Epub 2020 Jul 19 doi: 10.3322/caac.21626. PMID: 32683683Free PMC Article
Pancreatic cancer: An update on diagnosis and management.
Loveday BPT, Lipton L, Thomson BN
Aust J Gen Pract 2019 Dec;48(12):826-831. doi: 10.31128/AJGP-06-19-4957. PMID: 31774983
Total Neoadjuvant Therapy With FOLFIRINOX in Combination With Losartan Followed by Chemoradiotherapy for Locally Advanced Pancreatic Cancer: A Phase 2 Clinical Trial.
Murphy JE, Wo JY, Ryan DP, Clark JW, Jiang W, Yeap BY, Drapek LC, Ly L, Baglini CV, Blaszkowsky LS, Ferrone CR, Parikh AR, Weekes CD, Nipp RD, Kwak EL, Allen JN, Corcoran RB, Ting DT, Faris JE, Zhu AX, Goyal L, Berger DL, Qadan M, Lillemoe KD, Talele N, Jain RK, DeLaney TF, Duda DG, Boucher Y, Fernández-Del Castillo C, Hong TS
JAMA Oncol 2019 Jul 1;5(7):1020-1027. doi: 10.1001/jamaoncol.2019.0892. PMID: 31145418Free PMC Article
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

Prognosis

Cholangiocarcinoma landscape in Europe: Diagnostic, prognostic and therapeutic insights from the ENSCCA Registry.
Izquierdo-Sanchez L, Lamarca A, La Casta A, Buettner S, Utpatel K, Klümpen HJ, Adeva J, Vogel A, Lleo A, Fabris L, Ponz-Sarvise M, Brustia R, Cardinale V, Braconi C, Vidili G, Jamieson NB, Macias RI, Jonas JP, Marzioni M, Hołówko W, Folseraas T, Kupčinskas J, Sparchez Z, Krawczyk M, Krupa Ł, Scripcariu V, Grazi GL, Landa-Magdalena A, Ijzermans JN, Evert K, Erdmann JI, López-López F, Saborowski A, Scheiter A, Santos-Laso A, Carpino G, Andersen JB, Marin JJ, Alvaro D, Bujanda L, Forner A, Valle JW, Koerkamp BG, Banales JM
J Hepatol 2022 May;76(5):1109-1121. Epub 2022 Feb 12 doi: 10.1016/j.jhep.2021.12.010. PMID: 35167909
Pancreatic Cancer: A Review.
Park W, Chawla A, O'Reilly EM
JAMA 2021 Sep 7;326(9):851-862. doi: 10.1001/jama.2021.13027. PMID: 34547082Free PMC Article
Multidisciplinary standards of care and recent progress in pancreatic ductal adenocarcinoma.
Grossberg AJ, Chu LC, Deig CR, Fishman EK, Hwang WL, Maitra A, Marks DL, Mehta A, Nabavizadeh N, Simeone DM, Weekes CD, Thomas CR Jr
CA Cancer J Clin 2020 Sep;70(5):375-403. Epub 2020 Jul 19 doi: 10.3322/caac.21626. PMID: 32683683Free PMC Article
Total Neoadjuvant Therapy With FOLFIRINOX in Combination With Losartan Followed by Chemoradiotherapy for Locally Advanced Pancreatic Cancer: A Phase 2 Clinical Trial.
Murphy JE, Wo JY, Ryan DP, Clark JW, Jiang W, Yeap BY, Drapek LC, Ly L, Baglini CV, Blaszkowsky LS, Ferrone CR, Parikh AR, Weekes CD, Nipp RD, Kwak EL, Allen JN, Corcoran RB, Ting DT, Faris JE, Zhu AX, Goyal L, Berger DL, Qadan M, Lillemoe KD, Talele N, Jain RK, DeLaney TF, Duda DG, Boucher Y, Fernández-Del Castillo C, Hong TS
JAMA Oncol 2019 Jul 1;5(7):1020-1027. doi: 10.1001/jamaoncol.2019.0892. PMID: 31145418Free PMC Article
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

Clinical prediction guides

The molecular landscape of pancreatic ductal adenocarcinoma.
Sivapalan L, Kocher HM, Ross-Adams H, Chelala C
Pancreatology 2022 Nov;22(7):925-936. Epub 2022 Jul 21 doi: 10.1016/j.pan.2022.07.010. PMID: 35927150
Cholangiocarcinoma landscape in Europe: Diagnostic, prognostic and therapeutic insights from the ENSCCA Registry.
Izquierdo-Sanchez L, Lamarca A, La Casta A, Buettner S, Utpatel K, Klümpen HJ, Adeva J, Vogel A, Lleo A, Fabris L, Ponz-Sarvise M, Brustia R, Cardinale V, Braconi C, Vidili G, Jamieson NB, Macias RI, Jonas JP, Marzioni M, Hołówko W, Folseraas T, Kupčinskas J, Sparchez Z, Krawczyk M, Krupa Ł, Scripcariu V, Grazi GL, Landa-Magdalena A, Ijzermans JN, Evert K, Erdmann JI, López-López F, Saborowski A, Scheiter A, Santos-Laso A, Carpino G, Andersen JB, Marin JJ, Alvaro D, Bujanda L, Forner A, Valle JW, Koerkamp BG, Banales JM
J Hepatol 2022 May;76(5):1109-1121. Epub 2022 Feb 12 doi: 10.1016/j.jhep.2021.12.010. PMID: 35167909
Pancreatic Cancer: A Review.
Park W, Chawla A, O'Reilly EM
JAMA 2021 Sep 7;326(9):851-862. doi: 10.1001/jama.2021.13027. PMID: 34547082Free PMC Article
The Multidisciplinary Approach to Localized Pancreatic Adenocarcinoma.
Parekh HD, Starr J, George TJ Jr
Curr Treat Options Oncol 2017 Nov 16;18(12):73. doi: 10.1007/s11864-017-0515-8. PMID: 29143898
Pancreatic adenocarcinoma.
Howard TJ
Curr Probl Cancer 1996 Sep-Oct;20(5):281-328. doi: 10.1016/s0147-0272(96)80001-8. PMID: 8902402

Recent systematic reviews

Intraperitoneal chemotherapy in the management of pancreatic adenocarcinoma: A systematic review and meta-analysis.
Frassini S, Calabretto F, Granieri S, Fugazzola P, Viganò J, Fazzini N, Ansaloni L, Cobianchi L
Eur J Surg Oncol 2022 Sep;48(9):1911-1921. Epub 2022 Jun 2 doi: 10.1016/j.ejso.2022.05.030. PMID: 35688711
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
Survival equivalence in patients treated for borderline resectable and unresectable locally advanced pancreatic ductal adenocarcinoma: a systematic review and network meta-analysis.
Lindemann J, du Toit L, Kotze U, Bernon M, Krige J, Jonas E
HPB (Oxford) 2021 Feb;23(2):173-186. Epub 2020 Oct 22 doi: 10.1016/j.hpb.2020.09.022. PMID: 33268268
Systematic review of novel ablative methods in locally advanced pancreatic cancer.
Keane MG, Bramis K, Pereira SP, Fusai GK
World J Gastroenterol 2014 Mar 7;20(9):2267-78. doi: 10.3748/wjg.v20.i9.2267. PMID: 24605026Free PMC Article
Radiofrequency ablation for unresectable locally advanced pancreatic cancer: a systematic review.
Fegrachi S, Besselink MG, van Santvoort HC, van Hillegersberg R, Molenaar IQ
HPB (Oxford) 2014 Feb;16(2):119-23. Epub 2013 Apr 18 doi: 10.1111/hpb.12097. PMID: 23600801Free PMC Article

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