Consensus on the treatment of pancreatic cancer in Spain

Manuel Hidalgo, Albert Abad, Enrique Aranda, Luis Díez, Jaime Feliu, Carlos Gómez, Antonio Irigoyen, Rafael López, Fernando Rivera, Carmen Rubio, Javier Sastre, Josep Tabernero, Eduardo Díaz-Rubio

Research output: Contribution to journalReview article

Abstract

Pancreatic cancer (PC) represents one of the greatest oncological challenges of our century, due to its high mortality and incidence. A group of Spanish experts in PC treatment reviewed data available on different therapeutic combinations and established consensus on what would be the best strategy in PC management, depending on the stage of the disease. Surgery with complete resection may produce 5-year survival rates of 18-24%, but definitive control is still precarious. In the absence of consensus, the best evidence suggests that adjuvant chemotherapy with gemcitabine for 6 months using the CONKO-001 regime is the treatment of choice after resection of PC for patients with acceptable functional status. This group recommends chemoradiotherapy (CT-RT) in patients with factors for poor loco-regional prognosis. However, chemotherapy is an option for the treatment of locally advanced PC in patients with good general status and in the absence of metastatic disease the recommended treatment is CT-RT followed by gemcitabine-based chemotherapy. A period of chemotherapy followed by consolidation CT-RT may be appropriate, as it allows selection of patients with locally advanced disease who may benefit most from combined treatment. Erlotinib combined with gemcitabine shows significant survival improvement in PC and must be considered an option in the first-line treatment of advanced and metastatic PC. The gemcitabine-erlotinib combination is proposed as the standard treatment for metastatic PC in patients with PS≥2. In patients with PS<2, gemcitabine-erlotinib is recommended as the first-line treatment option, supported by a maximum degree of evidence, without ruling out other options, such as gemcitabine-oxaliplatin, gemcitabine-capecitabine or gemcitabine alone.

Original languageEnglish (US)
Pages (from-to)290-301
Number of pages12
JournalClinical and Translational Oncology
Volume11
Issue number5
DOIs
StatePublished - May 1 2009

Keywords

  • Consensus document
  • Epidermal growth factor receptor inhibitor
  • Erlotinib
  • Pancreatic cancer
  • Spain

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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  • Cite this

    Hidalgo, M., Abad, A., Aranda, E., Díez, L., Feliu, J., Gómez, C., Irigoyen, A., López, R., Rivera, F., Rubio, C., Sastre, J., Tabernero, J., & Díaz-Rubio, E. (2009). Consensus on the treatment of pancreatic cancer in Spain. Clinical and Translational Oncology, 11(5), 290-301. https://doi.org/10.1007/s12094-009-0357-3