Update on the Management of Pancreatic Cancer in Older Adults
Pancreatic cancer is more common in older adults, who are underrepresented in clinical trials and frequently under treated. Chronological age alone should not deter clinicians from offering treatment to geriatric patients, as they are a heterogeneous population. Geriatric assessment, frailty assessment tools, and toxicity risk scores help clinicians select appropriate patients for therapy. For resectable disease, surgery can be safe but should be done at a high-volume center. Adjuvant therapy is important; though there remains controversy on the role of radiation, chemotherapy is well studied and efficacious. In locally advanced unresectable disease, chemoradiation or chemotherapy alone is an option. Neoadjuvant therapy improves the chances of resectability in borderline resectable disease. Chemotherapy extends survival in metastatic disease, but treatment goals and risk-benefit ratios have to be clarified. Adequate symptom management and supportive care are important. There are now many new treatment strategies and novel therapies for this disease.
KeywordsPancreatic adenocarcinoma Older adults Geriatric oncology Comprehensive geriatric assessment Frailty scores Toxicity scores Update Surgery Chemotherapy Radiation Chemoradiation Novel therapies Symptom management
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Conflict of Interest
Shin Yin Lee, Moussa Sissoko, and Kevan L. Hartshorn declare that they have no conflict of interest.
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This article does not contain any studies with human or animal subjects performed by any of the authors.
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