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Treatment Paradigms for Older Adults with Pancreatic Cancer: a Nuanced Approach

  • Upper Gastrointestinal Cancers (JD Berlin, Section Editor)
  • Published:
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Opinion statement

Pancreatic cancer is increasing in incidence in the USA. This disease disproportionately affects older adults, and as the percentage of adults > 65 years old increases with the aging of the baby boomers, the prevalence is expected to rise over the coming decade. These patients are often more susceptible to disease-related symptoms and have less ability to withstand both cancer and treatment-related side effects. Therefore, it is imperative that treating physicians thoughtfully consider their recommended treatment approach towards this vulnerable patient population. This review focuses on the current state of research of older adults with pancreatic adenocarcinoma, highlighting deficiencies in the representation of this patient population in clinical trials. It is vital that the treating physicians take a nuanced approach towards therapy of localized and metastatic disease in geriatric patients. A one size fits all treatment algorithm is no longer appropriate in any cancer patient, let alone the elders who are particularly vulnerable to developing treatment-related toxicities. To help guide therapy decisions, it is important to perform a comprehensive geriatric assessment which may uncover unexpected frailty and lead to a change in the recommended treatment approach. In this way, we can support older adults during therapy for this aggressive malignancy and provide optimal care.

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Authors and Affiliations

  1. Department of Medical Oncology, Inova Schar Cancer Institute, 8081 Innovation Park Drive, Fairfax, VA, 22031, USA

    Arthur Winer MD

  2. Department of Medical Oncology, Fox Chase Cancer, Philadelphia, PA, USA

    Efrat Dotan MD

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  1. Arthur Winer MD
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  2. Efrat Dotan MD
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Both authors were involved in drafting the manuscript.

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Correspondence to Arthur Winer MD.

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Conflict of Interest

Arthur Winer has received speaker’s honoraria from OncLive for speaking at an educational event on gastrointestinal cancers. Efrat Dotan has received institutional research funding from OncoMed, Pfizer, Eli Lilly, MedImmune, AstraZeneca, GlaxoSmithKline, Incyte, and Boston Biomedical (SDP Oncology); and has received compensation from Boston Biomedical (SDP Oncology), QED, Basilea, and ARMO BioSciences for service as a consultant/advisor.

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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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This article is part of the Topical Collection on Upper Gastrointestinal Cancers

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Winer, A., Dotan, E. Treatment Paradigms for Older Adults with Pancreatic Cancer: a Nuanced Approach. Curr. Treat. Options in Oncol. 22, 104 (2021). https://doi.org/10.1007/s11864-021-00892-7

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