Clinical Features and Treatment Modalities of PDAC Flashcards
What is pancreatic ductal adenocarcinoma (PDAC)?
PDAC is the most common malignancy of the pancreas, characterized by tubular adenocarcinoma of the ductal glands.
What are the clinical features of PDAC?
Clinical symptoms include back pain, loss of appetite, weight loss, new onset of diabetes, and painless jaundice.
Why is the diagnosis of PDAC often delayed?
Diagnosis is often delayed due to relatively unspecific clinical symptoms.
What imaging modalities are required for diagnosing PDAC?
High-resolution ultrasound, endoscopic ultrasound (EUS), computed tomography (CT), or magnetic resonance imaging (MRI) are required.
What percentage of PDAC patients are operable at diagnosis?
15-20% of patients can be operated on with complete removal of the pancreatic tumor.
What is the standard treatment for locally advanced or metastatic PDAC?
Systemic chemotherapy is the only treatment option for locally advanced or metastatic PDAC.
What was the standard of care chemotherapy for metastatic PDAC for several decades?
Gemcitabine monotherapy was the standard of care chemotherapy.
What is nab-paclitaxel and its significance in PDAC treatment?
Nab-paclitaxel is an albumin-bound, nano-formulated chemotherapy approved in 2013 that significantly prolonged survival in stage IV PDAC patients.
What is the role of SPARC in PDAC treatment?
SPARC is an albumin-binding protein that may predict the efficacy of nab-paclitaxel, although its predictive value has not been confirmed.
What is FOLFIRINOX?
FOLFIRINOX is a combination of 5-fluorouracil, leucovorin, oxaliplatin, and irinotecan, and is the most efficacious regimen for metastatic PDAC patients.
What was the outcome of the NAPOLI-1 trial?
The NAPOLI-1 trial showed that PDAC patients who progressed under gemcitabine-based therapy had a significant survival benefit with MM-398 compared to 5-FU folinic acid.
What is the projected survival rate for PDAC patients?
The 5-year survival rate for PDAC patients is below 10%, with a median survival of less than 12 months following diagnosis.
What is the future projection for PDAC as a cause of cancer-related death in the United States?
PDAC is projected to become the second leading cause of cancer-related death in the United States by 2030.
