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Metastatic Pancreatic Adenocarcinoma

MedGen UID:
163663
•Concept ID:
C0861727
•
Neoplastic Process

Definition

An adenocarcinoma that arises from the exocrine pancreatic tissue and has metastasized to other anatomic sites. [from NCI]

Professional guidelines

PubMed

Management of Metastatic Pancreatic Adenocarcinoma.
Cheema AR, O'Reilly EM
Surg Clin North Am 2016 Dec;96(6):1391-1414. doi: 10.1016/j.suc.2016.07.011. PMID: 27865284
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
Treatment of metastatic pancreatic adenocarcinoma: a review.
Thota R, Pauff JM, Berlin JD
Oncology (Williston Park) 2014 Jan;28(1):70-4. PMID: 24683721

Recent clinical studies

Etiology

A Phase I Expansion Cohort Study Evaluating the Safety and Efficacy of the CHK1 Inhibitor LY2880070 with Low-dose Gemcitabine in Patients with Metastatic Pancreatic Adenocarcinoma.
Huffman BM, Feng H, Parmar K, Wang J, Kapner KS, Kochupurakkal B, Martignetti DB, Sadatrezaei G, Abrams TA, Biller LH, Giannakis M, Ng K, Patel AK, Perez KJ, Singh H, Rubinson DA, Schlechter BL, Andrews E, Hannigan AM, Dunwell S, Getchell Z, Raghavan S, Wolpin BM, Fortier C, D'Andrea AD, Aguirre AJ, Shapiro GI, Cleary JM
Clin Cancer Res 2023 Dec 15;29(24):5047-5056. doi: 10.1158/1078-0432.CCR-23-2005. PMID: 37819936Free 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
CD40 agonistic monoclonal antibody APX005M (sotigalimab) and chemotherapy, with or without nivolumab, for the treatment of metastatic pancreatic adenocarcinoma: an open-label, multicentre, phase 1b study.
O'Hara MH, O'Reilly EM, Varadhachary G, Wolff RA, Wainberg ZA, Ko AH, Fisher G, Rahma O, Lyman JP, Cabanski CR, Mick R, Gherardini PF, Kitch LJ, Xu J, Samuel T, Karakunnel J, Fairchild J, Bucktrout S, LaVallee TM, Selinsky C, Till JE, Carpenter EL, Alanio C, Byrne KT, Chen RO, Trifan OC, Dugan U, Horak C, Hubbard-Lucey VM, Wherry EJ, Ibrahim R, Vonderheide RH
Lancet Oncol 2021 Jan;22(1):118-131. doi: 10.1016/S1470-2045(20)30532-5. PMID: 33387490
Liposomal Irinotecan: A Review in Metastatic Pancreatic Adenocarcinoma.
Lamb YN, Scott LJ
Drugs 2017 May;77(7):785-792. doi: 10.1007/s40265-017-0741-1. PMID: 28401446
Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine.
Von Hoff DD, Ervin T, Arena FP, Chiorean EG, Infante J, Moore M, Seay T, Tjulandin SA, Ma WW, Saleh MN, Harris M, Reni M, Dowden S, Laheru D, Bahary N, Ramanathan RK, Tabernero J, Hidalgo M, Goldstein D, Van Cutsem E, Wei X, Iglesias J, Renschler MF
N Engl J Med 2013 Oct 31;369(18):1691-703. Epub 2013 Oct 16 doi: 10.1056/NEJMoa1304369. PMID: 24131140Free PMC Article

Diagnosis

A Phase I Expansion Cohort Study Evaluating the Safety and Efficacy of the CHK1 Inhibitor LY2880070 with Low-dose Gemcitabine in Patients with Metastatic Pancreatic Adenocarcinoma.
Huffman BM, Feng H, Parmar K, Wang J, Kapner KS, Kochupurakkal B, Martignetti DB, Sadatrezaei G, Abrams TA, Biller LH, Giannakis M, Ng K, Patel AK, Perez KJ, Singh H, Rubinson DA, Schlechter BL, Andrews E, Hannigan AM, Dunwell S, Getchell Z, Raghavan S, Wolpin BM, Fortier C, D'Andrea AD, Aguirre AJ, Shapiro GI, Cleary JM
Clin Cancer Res 2023 Dec 15;29(24):5047-5056. doi: 10.1158/1078-0432.CCR-23-2005. PMID: 37819936Free PMC Article
Do patients with metastatic pancreatic adenocarcinoma to the lung have improved survival?
Ebrahimi A, Cham J, Puglisi L, De Shadarevian M, Hermel DJ, Spierling Bagsic SR, Sigal D
Cancer Med 2023 May;12(9):10243-10253. Epub 2023 Mar 14 doi: 10.1002/cam4.5751. PMID: 36916531Free 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
What treatment in 2017 for inoperable pancreatic cancers?
Taieb J, Pointet AL, Van Laethem JL, Laquente B, Pernot S, Lordick F, Reni M
Ann Oncol 2017 Jul 1;28(7):1473-1483. doi: 10.1093/annonc/mdx174. PMID: 28459988
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

Therapy

Gemcitabine and Paclitaxel Versus Gemcitabine Alone After 5-Fluorouracil, Oxaliplatin, and Irinotecan in Metastatic Pancreatic Adenocarcinoma: A Randomized Phase III PRODIGE 65-UCGI 36-GEMPAX UNICANCER Study.
De La Fouchardière C, Malka D, Cropet C, Chabaud S, Raimbourg J, Botsen D, Launay S, Evesque L, Vienot A, Perrier H, Jary M, Rinaldi Y, Coutzac C, Bachet JB, Neuzillet C, Williet N, Desgrippes R, Grainville T, Aparicio T, Peytier A, Lecomte T, Roth GS, Thirot-Bidault A, Lachaux N, Bouché O, Ghiringhelli F
J Clin Oncol 2024 Mar 20;42(9):1055-1066. Epub 2024 Jan 17 doi: 10.1200/JCO.23.00795. PMID: 38232341
Overall Survival Results From the POLO Trial: A Phase III Study of Active Maintenance Olaparib Versus Placebo for Germline BRCA-Mutated Metastatic Pancreatic Cancer.
Kindler HL, Hammel P, Reni M, Van Cutsem E, Macarulla T, Hall MJ, Park JO, Hochhauser D, Arnold D, Oh DY, Reinacher-Schick A, Tortora G, Algül H, O'Reilly EM, Bordia S, McGuinness D, Cui K, Locker GY, Golan T
J Clin Oncol 2022 Dec 1;40(34):3929-3939. Epub 2022 Jul 14 doi: 10.1200/JCO.21.01604. PMID: 35834777Free 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
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
Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine.
Von Hoff DD, Ervin T, Arena FP, Chiorean EG, Infante J, Moore M, Seay T, Tjulandin SA, Ma WW, Saleh MN, Harris M, Reni M, Dowden S, Laheru D, Bahary N, Ramanathan RK, Tabernero J, Hidalgo M, Goldstein D, Van Cutsem E, Wei X, Iglesias J, Renschler MF
N Engl J Med 2013 Oct 31;369(18):1691-703. Epub 2013 Oct 16 doi: 10.1056/NEJMoa1304369. PMID: 24131140Free PMC Article

Prognosis

A Phase I Expansion Cohort Study Evaluating the Safety and Efficacy of the CHK1 Inhibitor LY2880070 with Low-dose Gemcitabine in Patients with Metastatic Pancreatic Adenocarcinoma.
Huffman BM, Feng H, Parmar K, Wang J, Kapner KS, Kochupurakkal B, Martignetti DB, Sadatrezaei G, Abrams TA, Biller LH, Giannakis M, Ng K, Patel AK, Perez KJ, Singh H, Rubinson DA, Schlechter BL, Andrews E, Hannigan AM, Dunwell S, Getchell Z, Raghavan S, Wolpin BM, Fortier C, D'Andrea AD, Aguirre AJ, Shapiro GI, Cleary JM
Clin Cancer Res 2023 Dec 15;29(24):5047-5056. doi: 10.1158/1078-0432.CCR-23-2005. PMID: 37819936Free PMC Article
A real-world analysis of trametinib in combination with hydroxychloroquine or CDK4/6 inhibitor as third- or later-line therapy in metastatic pancreatic adenocarcinoma.
Tang H, Ge Y, You T, Li X, Wang Y, Cheng Y, Bai C
BMC Cancer 2023 Oct 10;23(1):958. doi: 10.1186/s12885-023-11464-3. PMID: 37817078Free PMC Article
Do patients with metastatic pancreatic adenocarcinoma to the lung have improved survival?
Ebrahimi A, Cham J, Puglisi L, De Shadarevian M, Hermel DJ, Spierling Bagsic SR, Sigal D
Cancer Med 2023 May;12(9):10243-10253. Epub 2023 Mar 14 doi: 10.1002/cam4.5751. PMID: 36916531Free PMC Article
Are targeted therapies or immunotherapies effective in metastatic pancreatic adenocarcinoma?
Rémond MS, Pellat A, Brezault C, Dhooge M, Coriat R
ESMO Open 2022 Dec;7(6):100638. Epub 2022 Nov 16 doi: 10.1016/j.esmoop.2022.100638. PMID: 36399952Free PMC Article
Current Standards and Novel Treatment Options for Metastatic Pancreatic Adenocarcinoma.
Weinberg BA, Yabar CS, Brody JR, Pishvaian MJ
Oncology (Williston Park) 2015 Nov;29(11):809-20, 886. PMID: 26573060

Clinical prediction guides

Overall Survival Results From the POLO Trial: A Phase III Study of Active Maintenance Olaparib Versus Placebo for Germline BRCA-Mutated Metastatic Pancreatic Cancer.
Kindler HL, Hammel P, Reni M, Van Cutsem E, Macarulla T, Hall MJ, Park JO, Hochhauser D, Arnold D, Oh DY, Reinacher-Schick A, Tortora G, Algül H, O'Reilly EM, Bordia S, McGuinness D, Cui K, Locker GY, Golan T
J Clin Oncol 2022 Dec 1;40(34):3929-3939. Epub 2022 Jul 14 doi: 10.1200/JCO.21.01604. PMID: 35834777Free 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
CD40 agonistic monoclonal antibody APX005M (sotigalimab) and chemotherapy, with or without nivolumab, for the treatment of metastatic pancreatic adenocarcinoma: an open-label, multicentre, phase 1b study.
O'Hara MH, O'Reilly EM, Varadhachary G, Wolff RA, Wainberg ZA, Ko AH, Fisher G, Rahma O, Lyman JP, Cabanski CR, Mick R, Gherardini PF, Kitch LJ, Xu J, Samuel T, Karakunnel J, Fairchild J, Bucktrout S, LaVallee TM, Selinsky C, Till JE, Carpenter EL, Alanio C, Byrne KT, Chen RO, Trifan OC, Dugan U, Horak C, Hubbard-Lucey VM, Wherry EJ, Ibrahim R, Vonderheide RH
Lancet Oncol 2021 Jan;22(1):118-131. doi: 10.1016/S1470-2045(20)30532-5. PMID: 33387490
Liposomal Irinotecan: A Review in Metastatic Pancreatic Adenocarcinoma.
Frampton JE
Drugs 2020 Jul;80(10):1007-1018. doi: 10.1007/s40265-020-01336-6. PMID: 32557396Free PMC Article
Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine.
Von Hoff DD, Ervin T, Arena FP, Chiorean EG, Infante J, Moore M, Seay T, Tjulandin SA, Ma WW, Saleh MN, Harris M, Reni M, Dowden S, Laheru D, Bahary N, Ramanathan RK, Tabernero J, Hidalgo M, Goldstein D, Van Cutsem E, Wei X, Iglesias J, Renschler MF
N Engl J Med 2013 Oct 31;369(18):1691-703. Epub 2013 Oct 16 doi: 10.1056/NEJMoa1304369. PMID: 24131140Free PMC Article

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