TY - JOUR
T1 - Consensus on the treatment of pancreatic cancer in Spain
AU - Hidalgo, Manuel
AU - Abad, Albert
AU - Aranda, Enrique
AU - Díez, Luis
AU - Feliu, Jaime
AU - Gómez, Carlos
AU - Irigoyen, Antonio
AU - López, Rafael
AU - Rivera, Fernando
AU - Rubio, Carmen
AU - Sastre, Javier
AU - Tabernero, Josep
AU - Díaz-Rubio, Eduardo
PY - 2009/5
Y1 - 2009/5
N2 - 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.
AB - 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.
KW - Consensus document
KW - Epidermal growth factor receptor inhibitor
KW - Erlotinib
KW - Pancreatic cancer
KW - Spain
UR - http://www.scopus.com/inward/record.url?scp=68849087986&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=68849087986&partnerID=8YFLogxK
U2 - 10.1007/s12094-009-0357-3
DO - 10.1007/s12094-009-0357-3
M3 - Review article
C2 - 19451062
AN - SCOPUS:68849087986
SN - 1699-048X
VL - 11
SP - 290
EP - 301
JO - Clinical and Translational Oncology
JF - Clinical and Translational Oncology
IS - 5
ER -