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Practice Guideline
. 2021 May;23(5):988-1000.
doi: 10.1007/s12094-021-02573-1. Epub 2021 Mar 3.

SEOM clinical guidelines for pancreatic and biliary tract cancer (2020)

Mª A Gómez-España  1 , A F Montes  2 , R Garcia-Carbonero  3 , T M Mercadé  4 , J Maurel  5 , A M Martín  6 , R Pazo-Cid  7 , R Vera  8 , A Carrato  9 , J Feliu  10
Affiliations
Practice Guideline

SEOM clinical guidelines for pancreatic and biliary tract cancer (2020)

Mª A Gómez-España et al. Clin Transl Oncol. 2021 May.

Abstract

Pancreatic cancer (PC) and biliary tract cancer (BTC) are both aggressive and highly fatal malignancies. Nowadays we have a profound knowledge about the molecular landscape of these neoplasms and this has allowed new therapeutic options. Surgery is the only potentially curative therapy in both cancers, but disease recurrence is frequent. In PC, adjuvant treatment with mFOLFIRINOX has improved overall survival (OS) and in BTC adjuvant treatment with capecitabine seems to improve OS and relapse-free survival. Concomitant radio-chemotherapy could also be considered following R1 surgery in both neoplasms. Neoadjuvant treatment represents the best option for achieving an R0 resection in borderline PC. Upfront systemic chemotherapy is the treatment of choice in unresectable locally advanced PC and BTC; then locoregional therapy could be considered after an initial period of at least 3-4 months of systemic chemotherapy. In metastatic PC, FOLFIRINOX or Gemcitabine plus nab-paclitaxel have improved OS compared with gemcitabine alone. In metastatic BTC, cisplatin plus gemcitabine constitute the standard treatment. Progress in the knowledge of molecular biology has enabled the identification of new targets for therapy with encouraging results that could in the future improve the survival and quality of life of patients with PC and BTC.

Keywords: Biliary tract cancer; Chemotherapy; Pancreatic cancer; Radiotherapy; Treatment.

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Conflict of interest statement

AGE reports travel and accommodation from Roche, Amgen, Merck, Servier. AFM don't have conflict of interests. RGC has provided scientific advice and/or received honoraria or funding for continuous medical education from AAA, Advanz Pharma, Amgen, Bayer, BMS, HMP, Ipsen, Merck, Midatech Pharma, MSD, Novartis, PharmaMar, Pfizer, Pierre Fabre, Roche, Servier and Sanofi, and has received research support from Pfizer and BMS. TM reports consultancy/advisory role with Amgen, Baxter, Celgene, Incyte, Q&D Therapeutics, Serviere, Shire, AstraZeneca; research funding from AstraZeneca, BeiGene and Celgene. JM reports research grants from Merck, Amgen, NanoString, Incyte and Biocartis. Also reports personal fees from Advance Medical, Sirtex, Pierre-Fabre, Shire, Astra-Zeneca, Bayer, Servier, Sanofi and Roche. Funded by grants to JM from Catalan Agency for Management of University and Research Grants (AGAUR) (2014-SGR-474 and 2017-SGR-1174), Fundació la Marató de TV3 (201330.10), Instituto de Salud Carlos III (PI13/01728 and PI19/00740) and Fundacion Olga Torres (Modalitat A. 2019/2020). AMM reports Consulting, lectures and advisory board from Sanofi, Celgene, Astra-Zeneca, Roche, Leo Pharma, Servier, Pfizer, Bristol-Myers Squibb, Daiichi Sankyo, Bayer, Amgen, Rovi, Incyte, Merck Sharp & Dohme and Lilly. Research funding from Sanofi, LEO Pharma and Celgene. Travel and acccommodations from Roche, Merck Serono, Amgen and Celgene. RPC reports honoraria from Eisai, Roche, MSD, BMS, Celgene and Shire. RV reports personal fees, consulting and travel and accommodation from Roche, Amgen, Merck, Sanofi, BMS, Servier and MSD. AC reports consulting or advisory role from Roche, Bayer, Merck, Celgene, Shire, Servier and MSD Oncology. Travel, accommodation and expenses from Merck, Celgene and BMS. JF reports consulting or advisory role from Roche, Amgen, Eisai, Servier, Syrtex, Novartis and Merck. Travel, accommodation and expenses from Servier and Amgen. Research grants from Amgen and Merck.

Figures

Fig. 1
Fig. 1
Frequent genomic alterations in biliary tract cancers according to anatomic location. ICC intrahepatic cholangiocarcinoma, ECC extrahepatic cholangiocarcinoma, GBC gallbladder cancer. The most clinically promising drug targets are highlighted in bold type
See this image and copyright information in PMC

References

    1. GBD 2017 Pancreatic cancer collaborators. The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol. 2019;4:934–947. doi: 10.1016/S2468-1253(19)30347-4. - DOI - PMC - PubMed
    1. Rhim AD, Mirek ET, Aiello NM, et al. EMT and dissemination precede pancreatic tumor formation. Cell. 2012;148:349–361. doi: 10.1016/j.cell.2011.11.025. - DOI - PMC - PubMed
    1. Collison EA, Bailey P, Chang DK, et al. Molecular subtypes of pancreatic cancer. Nat Rev Gastroenterol Hepatol. 2019;16(4):207–220. doi: 10.1038/s41575-0190109-y. - DOI - PubMed
    1. O’Kane GM, Grünwald BT, Jang GH, et al. GATA6 expression distinguishes classical and basal-like subtypes in advanced pancreatic cancer. Clin Can Res. 2020 doi: 10.1158/1078-0432.CCR-19-3724. - DOI - PubMed
    1. Zao SG, Chen WS, Das R, et al. Clinical and genomic implications of luminal and basal subtypes across carcinomas. Clin Can Res. 2019;25(8):2450–2457. doi: 10.1158/1078-0432.CCR-18-3121. - DOI - PubMed

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