Update on the Management of Pancreatic Cancer in Older Adults

• Published in: Current Oncology Reports 2016-10, Vol.18 (10), p.60, Article 60
• Main Authors: Lee, Shin Yin, Sissoko, Moussa, Hartshorn, Kevan L.
• Format: Article
• Language: English
• Subjects: Aged; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Chemoradiotherapy; Combined Modality Therapy; Geriatric Assessment - methods; Geriatric Oncology (AR MacKenzie; Humans; Medicine; Medicine & Public Health; Neoadjuvant Therapy; Oncology; Pancreatic cancer; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - therapy; Patient Selection; Practice Guidelines as Topic; Prognosis; Risk Assessment; Section Editor; Survival Rate; Topical Collection on Geriatric Oncology
• ISSN: 1523-3790; 1534-6269
• DOI: 10.1007/s11912-016-0547-4

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.