Sohal Davendra P S, Kennedy Erin B, Cinar Pelin, Conroy Thierry, Copur Mehmet S, Crane Christopher H, Garrido-Laguna Ignacio, Lau Michelle W, Johnson Tyler, Krishnamurthi Smitha, Moravek Cassadie, O'Reilly Eileen M, Philip Philip A, Pant Shubham, Shah Manish A, Sahai Vaibhav, Uronis Hope E, Zaidi Neeha, Laheru Daniel
University of Cincinnati, Cincinnati, OH.
American Society of Clinical Oncology, Alexandria, VA.
J Clin Oncol. 2020 Sep 20;38(27):3217-3230. doi: 10.1200/JCO.20.01364. Epub 2020 Aug 5.
The aim of this work was to provide an update to the ASCO guideline on metastatic pancreatic cancer pertaining to recommendations for therapy options after first-line treatment.
ASCO convened an Expert Panel and conducted a systematic review to update guideline recommendations for second-line therapy for metastatic pancreatic cancer.
One randomized controlled trial of olaparib versus placebo, one report on phase I and II studies of larotrectinib, and one report on phase I and II studies of entrectinib met the inclusion criteria and inform the guideline update.
New or updated recommendations for germline and somatic testing for microsatellite instability high/mismatch repair deficiency, mutations, and TRK alterations are provided for all treatment-eligible patients to select patients for recommended therapies, including pembrolizumab, olaparib, larotrectinib, or entrectinib, or potential clinical trials. The Expert Panel continues to endorse the remaining recommendations for second-line chemotherapy, as well as other recommendations related to treatment, follow-up, and palliative care from the 2018 version of this guideline. Additional information is available at www.asco.org/gastrointestinal-cancer-guidelines.
本研究旨在更新美国临床肿瘤学会（ASCO）关于转移性胰腺癌的指南，内容涉及一线治疗后治疗方案的推荐。
ASCO召集了一个专家小组并进行了系统评价，以更新转移性胰腺癌二线治疗的指南推荐。
一项奥拉帕尼对比安慰剂的随机对照试验、一份关于拉罗替尼的I期和II期研究报告以及一份关于恩曲替尼的I期和II期研究报告符合纳入标准，并为指南更新提供了依据。
为所有符合治疗条件的患者提供了关于微卫星高度不稳定/错配修复缺陷、突变和TRK改变的种系和体细胞检测的新的或更新的推荐意见，以便选择适合接受推荐治疗的患者，这些治疗包括帕博利珠单抗、奥拉帕尼、拉罗替尼或恩曲替尼，或参与潜在的临床试验。专家小组继续支持2018年版本指南中关于二线化疗的其余推荐意见，以及与治疗、随访和姑息治疗相关的其他推荐意见。更多信息可在www.asco.org/gastrointestinal-cancer-guidelines查询。
