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TTD consensus document on the diagnosis and management of exocrine pancreatic cancer

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Abstract

Exocrine pancreatic cancer (PC) is a very aggressive and heterogeneous tumor with several cellular signaling pathways implicated in its pathogenesis and maintenance. Several risk factors increase the risk of developing PC. Therapeutic strategies used are dictated by the extent of disease. Supportive treatment is critical because of the high frequency of symptoms. For localized disease, surgery followed by adjuvant gemcitabine is the standard. Neoadjuvant and new adjuvant chemotherapy regimens are being evaluated. Locally advanced disease should respond best guided by a multidisciplinary team. Various treatment options are appropriate such as chemotherapy alone or chemoradiotherapy with integration of rescue surgery if the tumor becomes resectable. In metastatic disease, chemotherapy should be reserved for patients with ECOG 0–1 using Folfirinox or gemcitabine plus nab-paclitaxel as the most recommended options. Several therapeutic strategies targeting unregulated pathways are under evaluation with an unmet need for biomarkers to guide management.

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Authors and Affiliations

  1. Hospital Regional Universitario Carlos Haya, Málaga, Spain

    M. Benavides & I. Ales

  2. Hospital Sanitas Milenium Iradier, Barcelona, Spain

    A. Abad

  3. Hospital Universitario Ramón y Cajal, Madrid, Spain

    A. Carrato

  4. Medical Oncology Department, HC San Carlos; Center affiliated to the Red Temática de Investigación Cooperativa (RD06/0020/0021), Instituto Carlos III, Spanish Ministry of Science and Innovation, Madrid, Spain

    E. Díaz Rubio

  5. Hospital General Universitario de Elche, Alicante, Spain

    J. Gallego

  6. Departamento de Oncología, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain

    J. García-Foncillas

  7. Hospital Universitario 12 de Octubre, Madrid, Spain

    C. Grávalos

  8. Instituto Catalán de Oncología, Hospital Duran i Reynals, Barcelona, Spain

    B. Laquente

  9. Hospital de Sabadell, Corporación Sanitaria ParcTauli, Barcelona, Spain

    C. Pericay

  10. Hospital Universitario Marqués de Valdecilla, Santander, Spain

    F. Rivera

  11. Vall d’Hebron University Hospital, Barcelona, Spain

    J. Tabernero

  12. Oncology Department, Maimonides Institute of Biomedical Research (IMIBIC), Reina Sofía Hospital, University of Córdoba, Córdoba, Spain

    E. Aranda

  13. Spanish Cancer Network (RTICC), Instituto de Salud Carlos III, Madrid, Spain

    E. Aranda

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  1. M. Benavides
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Correspondence to M. Benavides.

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Benavides, M., Abad, A., Ales, I. et al. TTD consensus document on the diagnosis and management of exocrine pancreatic cancer. Clin Transl Oncol 16, 865–878 (2014). https://doi.org/10.1007/s12094-014-1177-7

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