Evidence map›Paper›PMID 27247216›Full record

ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2016

Locally Advanced, Unresectable Pancreatic Cancer: American Society of Clinical Oncology Clinical Practice Guideline.

Edward P Balaban, Pamela B Mangu, Alok A Khorana, Manish A Shah, Somnath Mukherjee, Christopher H Crane, Milind M Javle, Jennifer R Eads, Peter Allen, Andrew H Ko and 6 more

3 registry-linked trialsAbstract read
PubMed Publisher
In one paragraph

Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 193 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
193citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03632850 completednot on this mapstarted 2019, after this paper: background citation

Shared Decision-making: Investigating the Potential of an Interactive, Web-Based, Information Tool for People With Advanced Pancreatic Cancer

TypeobservationalSponsorBournemouth UniversityRan2019 to 2021Enrolled34ConditionsAdvanced Pancreatic CancerArmsweb-based interactive tool
NCT04276857 narecruitingnot on this mapstarted 2025, after this paper: background citation

Systemic Therapy With a Loco-regional Treatment in Patients With Locally Advanced Pancreatic Cancer: The SMART Study

TypeinterventionalSponsorUniversity of SaskatchewanRan2025 to 2026Enrolled27ConditionsLocally Advanced Pancreatic Cancer, Irreversible ElectroporationArmsIrreversible electroporation (NanoKnife® )
NCT04986930 phase2active not recruitingnot on this mapstarted 2021, after this paper: background citation

Randomized Phase 2 Study of mFOLFIRINOX With or Without Stereotactic Body Radiotherapy in Patients With Locally Advanced Pancreatic Adenocarcinoma

TypeinterventionalSponsorAsan Medical CenterRan2021 to 2025Enrolled92ConditionsPancreatic Adenocarcinoma, Pancreatic Cancer Non-resectableArmsSBRT+mFOLFIRINOX, mFOLFIRINOX
3 · Its place in the literature

Who cites it

193 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Metastatic Pancreatic Cancer: ASCO Clinical Practice Guideline Update.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2018
    Pooled it
  4. ACG Clinical Guideline: Diagnosis and Management of Pancreatic Cysts.The American journal of gastroenterology · 2018
    Guideline
  5. Pooled it
  6. Trial
  7. The impact of early palliative care on the quality of life of patients with advanced pancreatic cancer: The IMPERATIVE case-crossover study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023
    Trial
  8. Trial
  9. Trial
  10. Trial
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Correlation ofClinical oncology (Royal College of Radiologists (Great Britain)) · 2017
    Trial
  16. Review
  17. Article
  18. Article
  19. Review
  20. Article

133 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

Edward P BalabanEdward P. Balaban, Cancer Care Partnership, State College; Edward P. Balaban and Nelson S. Yee, Penn State Hershey Cancer Institute, Hershey, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Alok A. Khorana, Cleveland Clinic; Jennifer R. Eads, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH; Manish A. Shah, The Weill Cornell Medical Center; Peter Allen, Memorial Sloan Kettering Cancer Center, New York, NY; Somnath Mukherjee, University of Oxford, Oxford, United Kingdom; Christopher H. Crane and Milind M. Javle, The University of Texas MD Anderson Cancer Center, Houston, TX; Andrew H. Ko, University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Anitra Engebretson, Patient Representative, Portland, OR; Joseph M. Herman, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; John H. Strickler, Duke University Medical Center, Durham, NC; Al B. Benson III, Lurie Comprehensive Cancer Center of Northwestern, Chicago, IL; and Susan Urba, University of Michigan Cancer Center, Ann Arbor, MI.
Pamela B ManguEdward P. Balaban, Cancer Care Partnership, State College; Edward P. Balaban and Nelson S. Yee, Penn State Hershey Cancer Institute, Hershey, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Alok A. Khorana, Cleveland Clinic; Jennifer R. Eads, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH; Manish A. Shah, The Weill Cornell Medical Center; Peter Allen, Memorial Sloan Kettering Cancer Center, New York, NY; Somnath Mukherjee, University of Oxford, Oxford, United Kingdom; Christopher H. Crane and Milind M. Javle, The University of Texas MD Anderson Cancer Center, Houston, TX; Andrew H. Ko, University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Anitra Engebretson, Patient Representative, Portland, OR; Joseph M. Herman, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; John H. Strickler, Duke University Medical Center, Durham, NC; Al B. Benson III, Lurie Comprehensive Cancer Center of Northwestern, Chicago, IL; and Susan Urba, University of Michigan Cancer Center, Ann Arbor, MI.
Alok A KhoranaEdward P. Balaban, Cancer Care Partnership, State College; Edward P. Balaban and Nelson S. Yee, Penn State Hershey Cancer Institute, Hershey, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Alok A. Khorana, Cleveland Clinic; Jennifer R. Eads, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH; Manish A. Shah, The Weill Cornell Medical Center; Peter Allen, Memorial Sloan Kettering Cancer Center, New York, NY; Somnath Mukherjee, University of Oxford, Oxford, United Kingdom; Christopher H. Crane and Milind M. Javle, The University of Texas MD Anderson Cancer Center, Houston, TX; Andrew H. Ko, University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Anitra Engebretson, Patient Representative, Portland, OR; Joseph M. Herman, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; John H. Strickler, Duke University Medical Center, Durham, NC; Al B. Benson III, Lurie Comprehensive Cancer Center of Northwestern, Chicago, IL; and Susan Urba, University of Michigan Cancer Center, Ann Arbor, MI.
Manish A ShahEdward P. Balaban, Cancer Care Partnership, State College; Edward P. Balaban and Nelson S. Yee, Penn State Hershey Cancer Institute, Hershey, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Alok A. Khorana, Cleveland Clinic; Jennifer R. Eads, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH; Manish A. Shah, The Weill Cornell Medical Center; Peter Allen, Memorial Sloan Kettering Cancer Center, New York, NY; Somnath Mukherjee, University of Oxford, Oxford, United Kingdom; Christopher H. Crane and Milind M. Javle, The University of Texas MD Anderson Cancer Center, Houston, TX; Andrew H. Ko, University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Anitra Engebretson, Patient Representative, Portland, OR; Joseph M. Herman, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; John H. Strickler, Duke University Medical Center, Durham, NC; Al B. Benson III, Lurie Comprehensive Cancer Center of Northwestern, Chicago, IL; and Susan Urba, University of Michigan Cancer Center, Ann Arbor, MI.
Somnath MukherjeeEdward P. Balaban, Cancer Care Partnership, State College; Edward P. Balaban and Nelson S. Yee, Penn State Hershey Cancer Institute, Hershey, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Alok A. Khorana, Cleveland Clinic; Jennifer R. Eads, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH; Manish A. Shah, The Weill Cornell Medical Center; Peter Allen, Memorial Sloan Kettering Cancer Center, New York, NY; Somnath Mukherjee, University of Oxford, Oxford, United Kingdom; Christopher H. Crane and Milind M. Javle, The University of Texas MD Anderson Cancer Center, Houston, TX; Andrew H. Ko, University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Anitra Engebretson, Patient Representative, Portland, OR; Joseph M. Herman, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; John H. Strickler, Duke University Medical Center, Durham, NC; Al B. Benson III, Lurie Comprehensive Cancer Center of Northwestern, Chicago, IL; and Susan Urba, University of Michigan Cancer Center, Ann Arbor, MI.
Christopher H CraneEdward P. Balaban, Cancer Care Partnership, State College; Edward P. Balaban and Nelson S. Yee, Penn State Hershey Cancer Institute, Hershey, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Alok A. Khorana, Cleveland Clinic; Jennifer R. Eads, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH; Manish A. Shah, The Weill Cornell Medical Center; Peter Allen, Memorial Sloan Kettering Cancer Center, New York, NY; Somnath Mukherjee, University of Oxford, Oxford, United Kingdom; Christopher H. Crane and Milind M. Javle, The University of Texas MD Anderson Cancer Center, Houston, TX; Andrew H. Ko, University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Anitra Engebretson, Patient Representative, Portland, OR; Joseph M. Herman, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; John H. Strickler, Duke University Medical Center, Durham, NC; Al B. Benson III, Lurie Comprehensive Cancer Center of Northwestern, Chicago, IL; and Susan Urba, University of Michigan Cancer Center, Ann Arbor, MI.
Milind M JavleEdward P. Balaban, Cancer Care Partnership, State College; Edward P. Balaban and Nelson S. Yee, Penn State Hershey Cancer Institute, Hershey, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Alok A. Khorana, Cleveland Clinic; Jennifer R. Eads, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH; Manish A. Shah, The Weill Cornell Medical Center; Peter Allen, Memorial Sloan Kettering Cancer Center, New York, NY; Somnath Mukherjee, University of Oxford, Oxford, United Kingdom; Christopher H. Crane and Milind M. Javle, The University of Texas MD Anderson Cancer Center, Houston, TX; Andrew H. Ko, University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Anitra Engebretson, Patient Representative, Portland, OR; Joseph M. Herman, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; John H. Strickler, Duke University Medical Center, Durham, NC; Al B. Benson III, Lurie Comprehensive Cancer Center of Northwestern, Chicago, IL; and Susan Urba, University of Michigan Cancer Center, Ann Arbor, MI.
Jennifer R EadsEdward P. Balaban, Cancer Care Partnership, State College; Edward P. Balaban and Nelson S. Yee, Penn State Hershey Cancer Institute, Hershey, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Alok A. Khorana, Cleveland Clinic; Jennifer R. Eads, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH; Manish A. Shah, The Weill Cornell Medical Center; Peter Allen, Memorial Sloan Kettering Cancer Center, New York, NY; Somnath Mukherjee, University of Oxford, Oxford, United Kingdom; Christopher H. Crane and Milind M. Javle, The University of Texas MD Anderson Cancer Center, Houston, TX; Andrew H. Ko, University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Anitra Engebretson, Patient Representative, Portland, OR; Joseph M. Herman, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; John H. Strickler, Duke University Medical Center, Durham, NC; Al B. Benson III, Lurie Comprehensive Cancer Center of Northwestern, Chicago, IL; and Susan Urba, University of Michigan Cancer Center, Ann Arbor, MI.
Peter AllenEdward P. Balaban, Cancer Care Partnership, State College; Edward P. Balaban and Nelson S. Yee, Penn State Hershey Cancer Institute, Hershey, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Alok A. Khorana, Cleveland Clinic; Jennifer R. Eads, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH; Manish A. Shah, The Weill Cornell Medical Center; Peter Allen, Memorial Sloan Kettering Cancer Center, New York, NY; Somnath Mukherjee, University of Oxford, Oxford, United Kingdom; Christopher H. Crane and Milind M. Javle, The University of Texas MD Anderson Cancer Center, Houston, TX; Andrew H. Ko, University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Anitra Engebretson, Patient Representative, Portland, OR; Joseph M. Herman, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; John H. Strickler, Duke University Medical Center, Durham, NC; Al B. Benson III, Lurie Comprehensive Cancer Center of Northwestern, Chicago, IL; and Susan Urba, University of Michigan Cancer Center, Ann Arbor, MI.
Andrew H KoEdward P. Balaban, Cancer Care Partnership, State College; Edward P. Balaban and Nelson S. Yee, Penn State Hershey Cancer Institute, Hershey, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Alok A. Khorana, Cleveland Clinic; Jennifer R. Eads, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH; Manish A. Shah, The Weill Cornell Medical Center; Peter Allen, Memorial Sloan Kettering Cancer Center, New York, NY; Somnath Mukherjee, University of Oxford, Oxford, United Kingdom; Christopher H. Crane and Milind M. Javle, The University of Texas MD Anderson Cancer Center, Houston, TX; Andrew H. Ko, University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Anitra Engebretson, Patient Representative, Portland, OR; Joseph M. Herman, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; John H. Strickler, Duke University Medical Center, Durham, NC; Al B. Benson III, Lurie Comprehensive Cancer Center of Northwestern, Chicago, IL; and Susan Urba, University of Michigan Cancer Center, Ann Arbor, MI.
Anitra EngebretsonEdward P. Balaban, Cancer Care Partnership, State College; Edward P. Balaban and Nelson S. Yee, Penn State Hershey Cancer Institute, Hershey, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Alok A. Khorana, Cleveland Clinic; Jennifer R. Eads, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH; Manish A. Shah, The Weill Cornell Medical Center; Peter Allen, Memorial Sloan Kettering Cancer Center, New York, NY; Somnath Mukherjee, University of Oxford, Oxford, United Kingdom; Christopher H. Crane and Milind M. Javle, The University of Texas MD Anderson Cancer Center, Houston, TX; Andrew H. Ko, University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Anitra Engebretson, Patient Representative, Portland, OR; Joseph M. Herman, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; John H. Strickler, Duke University Medical Center, Durham, NC; Al B. Benson III, Lurie Comprehensive Cancer Center of Northwestern, Chicago, IL; and Susan Urba, University of Michigan Cancer Center, Ann Arbor, MI.
Joseph M HermanEdward P. Balaban, Cancer Care Partnership, State College; Edward P. Balaban and Nelson S. Yee, Penn State Hershey Cancer Institute, Hershey, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Alok A. Khorana, Cleveland Clinic; Jennifer R. Eads, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH; Manish A. Shah, The Weill Cornell Medical Center; Peter Allen, Memorial Sloan Kettering Cancer Center, New York, NY; Somnath Mukherjee, University of Oxford, Oxford, United Kingdom; Christopher H. Crane and Milind M. Javle, The University of Texas MD Anderson Cancer Center, Houston, TX; Andrew H. Ko, University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Anitra Engebretson, Patient Representative, Portland, OR; Joseph M. Herman, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; John H. Strickler, Duke University Medical Center, Durham, NC; Al B. Benson III, Lurie Comprehensive Cancer Center of Northwestern, Chicago, IL; and Susan Urba, University of Michigan Cancer Center, Ann Arbor, MI.
John H StricklerEdward P. Balaban, Cancer Care Partnership, State College; Edward P. Balaban and Nelson S. Yee, Penn State Hershey Cancer Institute, Hershey, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Alok A. Khorana, Cleveland Clinic; Jennifer R. Eads, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH; Manish A. Shah, The Weill Cornell Medical Center; Peter Allen, Memorial Sloan Kettering Cancer Center, New York, NY; Somnath Mukherjee, University of Oxford, Oxford, United Kingdom; Christopher H. Crane and Milind M. Javle, The University of Texas MD Anderson Cancer Center, Houston, TX; Andrew H. Ko, University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Anitra Engebretson, Patient Representative, Portland, OR; Joseph M. Herman, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; John H. Strickler, Duke University Medical Center, Durham, NC; Al B. Benson III, Lurie Comprehensive Cancer Center of Northwestern, Chicago, IL; and Susan Urba, University of Michigan Cancer Center, Ann Arbor, MI.
Al B BensonEdward P. Balaban, Cancer Care Partnership, State College; Edward P. Balaban and Nelson S. Yee, Penn State Hershey Cancer Institute, Hershey, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Alok A. Khorana, Cleveland Clinic; Jennifer R. Eads, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH; Manish A. Shah, The Weill Cornell Medical Center; Peter Allen, Memorial Sloan Kettering Cancer Center, New York, NY; Somnath Mukherjee, University of Oxford, Oxford, United Kingdom; Christopher H. Crane and Milind M. Javle, The University of Texas MD Anderson Cancer Center, Houston, TX; Andrew H. Ko, University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Anitra Engebretson, Patient Representative, Portland, OR; Joseph M. Herman, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; John H. Strickler, Duke University Medical Center, Durham, NC; Al B. Benson III, Lurie Comprehensive Cancer Center of Northwestern, Chicago, IL; and Susan Urba, University of Michigan Cancer Center, Ann Arbor, MI.
Susan UrbaEdward P. Balaban, Cancer Care Partnership, State College; Edward P. Balaban and Nelson S. Yee, Penn State Hershey Cancer Institute, Hershey, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Alok A. Khorana, Cleveland Clinic; Jennifer R. Eads, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH; Manish A. Shah, The Weill Cornell Medical Center; Peter Allen, Memorial Sloan Kettering Cancer Center, New York, NY; Somnath Mukherjee, University of Oxford, Oxford, United Kingdom; Christopher H. Crane and Milind M. Javle, The University of Texas MD Anderson Cancer Center, Houston, TX; Andrew H. Ko, University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Anitra Engebretson, Patient Representative, Portland, OR; Joseph M. Herman, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; John H. Strickler, Duke University Medical Center, Durham, NC; Al B. Benson III, Lurie Comprehensive Cancer Center of Northwestern, Chicago, IL; and Susan Urba, University of Michigan Cancer Center, Ann Arbor, MI.
Nelson S YeeEdward P. Balaban, Cancer Care Partnership, State College; Edward P. Balaban and Nelson S. Yee, Penn State Hershey Cancer Institute, Hershey, PA; Pamela B. Mangu, American Society of Clinical Oncology, Alexandria, VA; Alok A. Khorana, Cleveland Clinic; Jennifer R. Eads, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH; Manish A. Shah, The Weill Cornell Medical Center; Peter Allen, Memorial Sloan Kettering Cancer Center, New York, NY; Somnath Mukherjee, University of Oxford, Oxford, United Kingdom; Christopher H. Crane and Milind M. Javle, The University of Texas MD Anderson Cancer Center, Houston, TX; Andrew H. Ko, University of California San Francisco Comprehensive Cancer Center, San Francisco, CA; Anitra Engebretson, Patient Representative, Portland, OR; Joseph M. Herman, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; John H. Strickler, Duke University Medical Center, Durham, NC; Al B. Benson III, Lurie Comprehensive Cancer Center of Northwestern, Chicago, IL; and Susan Urba, University of Michigan Cancer Center, Ann Arbor, MI.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

purposeTo provide evidence-based recommendations to oncologists and others for treatment of patients with locally advanced, unresectable pancreatic cancer.

methodsAmerican Society of Clinical Oncology convened an Expert Panel of medical oncology, radiation oncology, surgical oncology, gastroenterology, palliative care, and advocacy experts and conducted a systematic review of the literature from January 2002 to June 2015. Outcomes included overall survival, disease-free survival, progression-free survival, and adverse events.

resultsTwenty-six randomized controlled trials met the systematic review criteria. RECOMMENDATIONS: A multiphase computed tomography scan of the chest, abdomen, and pelvis should be performed. Baseline performance status and comorbidity profile should be evaluated. The goals of care, patient preferences, psychological status, support systems, and symptoms should guide decisions for treatments. A palliative care referral should occur at first visit. Initial systemic chemotherapy (6 months) with a combination regimen is recommended for most patients (for some patients radiation therapy may be offered up front) with Eastern Cooperative Oncology Group performance status 0 or 1 and a favorable comorbidity profile. There is no clear evidence to support one regimen over another. The gemcitabine-based combinations and treatments recommended in the metastatic setting (eg, fluorouracil, leucovorin, irinotecan, and oxaliplatin and gemcitabine plus nanoparticle albumin-bound paclitaxel) have not been evaluated in randomized controlled trials involving locally advanced, unresectable pancreatic cancer. If there is local disease progression after induction chemotherapy, without metastasis, then radiation therapy or stereotactic body radiotherapy may be offered also with an Eastern Cooperative Oncology Group performance status ≤ 2 and an adequate comorbidity profile. If there is stable disease after 6 months of induction chemotherapy but unacceptable toxicities, radiation therapy may be offered as an alternative. Patients with disease progression should be offered treatment per the ASCO Metastatic Pancreatic Cancer Treatment Guideline. Follow-up visits every 3 to 4 months are recommended. Additional information is available at www.asco.org/guidelines/LAPC and www.asco.org/guidelines/MetPC and www.asco.org/guidelineswiki.

Indexed as

Practice Guidelines as TopicHumansMedical OncologyPancreatic NeoplasmsSocieties, MedicalUnited States

Identifiers

PMID27247216

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.