Consensus guidelines for diagnosis, treatment and follow-up of patients with pancreatic cancer in Spain

Abstract

The management of patients with pancreatic cancer has advanced over the last few years. We convey a multidisciplinary group of experts in an attempt to stablish practical guidelines for the diagnoses, staging and management of these patients. This paper summarizes the main conclusions of the working group. Patients with suspected pancreatic ductal adenocarcinoma should be rapidly evaluated and referred to high-volume centers. Multidisciplinary supervision is critical for proper diagnoses, staging and to frame a treatment plan. Surgical resection together with chemotherapy offers the highest chance for cure in early stage disease. Patients with advanced disease should be classified in treatment groups to guide systemic treatment. New chemotherapeutic regimens have resulted in improved survival. Symptomatic management is critical in this disease. Enrollment in a clinical trial is, in general, recommended.

Tumor-Infiltrating Immune Cell Signature Predicts the Prognosis and Chemosensitivity of Patients With Pancreatic Ductal Adenocarcinoma

“…Late and inefficient diagnosis and aggressive cancer biology largely determine the unfavorable outcomes of PDAC. Adjuvant systemic chemotherapy works as the first-line postoperative treatment to strive for a long-term survival (22). Thus, a highly accurate prognostic assessment and chemotherapy response prediction of PDAC are crucial for individualized surveillance plans and clinical decisions.…”

<p>Paeonol Inhibits Pancreatic Cancer Cell Migration and Invasion Through the Inhibition of TGF-β1/Smad Signaling and Epithelial-Mesenchymal-Transition</p>

“…27 In PDAC, more than 80% of the patients present with metastasis upon diagnosis. [27][28][29] Therefore, many efforts have been made in aims to suppress the metastatic property of PDAC. Metastasis is a complicated multi-step process involves the ability of cancer cell to detach by losing cellto-cell junction and cellular polarity, break away from the extracellular matrix, attain increased motility and increased invasive phenotype.…”

From First Line to Sequential Treatment in the Management of Metastatic Pancreatic Cancer

“…In addition, a recent Spanish consensus has also reviewed the different therapeutic options in mPDAC based on patient's characteristics 18 . As shown in Table 2 , for those patients that are candidates for chemotherapy treatment with no limitations, treatment options include nab-paclitaxel + GEM or FOLFIRINOX.…”

“…However, for those patients that are candidates for chemotherapy treatment with limitations, treatment options include the combination of nab-paclitaxel + GEM (ECOG 2 due to tumor burden) or either the combination of nab-paclitaxel + GEM or GEM monotherapy (ECOG 2 due to comorbidities). Finally, for those patients that are not candidates for chemotherapy treatment, the only option is support treatment in Palliate Care Units 18 .…”