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Cited by 1,882

The DOI matches its Crossref record; 84 of the 84 references it cites were found in a registry or an index.

Pancreatic Cancer: A Review

Open access
Park, Wungki, Chawla, Akhil, O’Reilly, Eileen M.·2021·JAMA
DOI 10.1001/jama.2021.13027
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Abstract

Importance: Pancreatic ductal adenocarcinoma (PDAC) is a relatively uncommon cancer, with approximately 60 430 new diagnoses expected in 2021 in the US. The incidence of PDAC is increasing by 0.5% to 1.0% per year, and it is projected to become the second-leading cause of cancer-related mortality by 2030. Observations: Effective screening is not available for PDAC, and most patients present with locally advanced (30%-35%) or metastatic (50%-55%) disease at diagnosis. A multidisciplinary management approach is recommended. Localized pancreas cancer includes resectable, borderline resectable (localized and involving major vascular structures), and locally advanced (unresectable) disease based on the degree of arterial and venous involvement by tumor, typically of the superior mesenteric vessels. For patients with resectable disease at presentation (10%-15%), surgery followed by adjuvant chemotherapy with FOLFIRINOX (fluorouracil, irinotecan, leucovorin, oxaliplatin) represents a standard therapeutic approach with an anticipated median overall survival of 54.4 months, compared with 35 months for single-agent gemcitabine (stratified hazard ratio for death, 0.64 [95% CI, 0.48-0.86]; P = .003). Neoadjuvant systemic therapy with or without radiation followed by evaluation for surgery is an accepted treatment approach for resectable and borderline resectable disease. For patients with locally advanced and unresectable disease due to extensive vascular involvement, systemic therapy followed by radiation is an option for definitive locoregional disease control. For patients with advanced (locally advanced and metastatic) PDAC, multiagent chemotherapy regimens, including FOLFIRINOX, gemcitabine/nab-paclitaxel, and nanoliposomal irinotecan/fluorouracil, all have a survival benefit of 2 to 6 months compared with a single-agent gemcitabine. For the 5% to 7% of patients with a BRCA pathogenic germline variant and metastatic PDAC, olaparib, a poly (adenosine diphosphate [ADB]-ribose) polymerase inhibitor, is a maintenance option that improves progression-free survival following initial platinum-based therapy. Conclusions and Relevance: Approximately 60 000 new cases of PDAC are diagnosed per year, and approximately 50% of patients have advanced disease at diagnosis. The incidence of PDAC is increasing. Currently available cytotoxic therapies for advanced disease are modestly effective. For all patients, multidisciplinary management, comprehensive germline testing, and integrated supportive care are recommended.

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Show all 84 references

Research works printed but not linked: 7

  1. Knox, 2020, Clinical advances in pancreas adenocarcinoma., Cancer Res, 80
  2. de Rooij, 2016, Minimally invasive versus open pancreatoduodenectomy: systematic review and meta-analysis of comparative cohort and registry studies., Ann Surg, 264, 257, 10.1097/SLA.0000000000001660 · doi:10.1097/sla.0000000000001660
  3. Neoptolemos, 2017, Comparison of adjuvant gemcitabine and capecitabine with gemcitabine monotherapy in patients with resected pancreatic cancer (ESPAC-4): a multicentre, open-label, randomised, phase 3 trial., Lancet, 389, 1011, 10.1016/S0140-6736(16)32409-6 · DOI · Paper page
  4. Glazer, 2014, A meta-analysis of randomized trials: immediate stent placement vs. surgical bypass in the palliative management of malignant biliary obstruction., J Pain Symptom Manage, 47, 307, 10.1016/j.jpainsymman.2013.03.013 · doi:10.1016/j.jpainsymman.2013.03.013
  5. Uemura, 2018, Endoscopic duodenal stent versus surgical gastrojejunostomy for gastric outlet obstruction in patients with advanced pancreatic cancer., Pancreatology, 18, 601, 10.1016/j.pan.2018.04.015 · doi:10.1016/j.pan.2018.04.015
  6. Florou, 2020, Treatment rechallenge with checkpoint inhibition in patients with mismatch repair-deficient pancreatic cancer after planned treatment interruption., JCO Precis Oncol, 4, 780, 10.1200/PO.20.00052 · doi:10.1200/po.20.00052
  7. Bendell, 2020, A phase I study to evaluate the safety and tolerability of AB680 combination therapy in participants with gastrointestinal malignancies., J Clin Oncol, 38, 10.1200/JCO.2020.38.4_suppl.TPS788 · doi:10.1200/jco.2020.38.4_suppl.tps788

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Metadata

Authors
Park, W., Chawla, A., & O’Reilly, E. M.
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2021-09-07
Volume
326
Issue
9
Pages
851
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.2021.13027
OpenAlex
W3197559541
Cited by
1,882
References
84
FWCI
89.11
Type
journal article
Language
en
Open access
green

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CoChat. (2026). Citation check: Pancreatic Cancer: A Review. https://app.cochat.ai/papers/10.1001/jama.2021.13027
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Park, W., Chawla, A., & O’Reilly, E. M. (2021). Pancreatic Cancer: A Review. JAMA. https://doi.org/10.1001/jama.2021.13027

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