Consensus and guidelines

Interpretation of 2023 2nd NCCN clinical practice guidelines in oncology-pancreatic adenocarcinoma

  • CHEN Jiahao ,
  • JIANG Chongyi
Expand
  • Department of Hepato-Biliary-Pancreatic & Splenic Surgery, Huadong Hospital, Fudan University, Shanghai 200040, China

Received date: 2023-12-14

  Online published: 2024-05-14

Abstract

Pancreatic adenocarcinoma, a severe digestive malignancy, is characterized by its poor prognosis. The National Comprehensive Cancer Network (NCCN) persistently refines its guidelines, integrating cutting-edge evidence-based medical insights to standardize the diagnostic and therapeutic strategies of pancreatic adenocarcinoma. The NCCN clinical practice guidelines in oncology-pancreatic adenocarcinoma were updated twice on May 4 and June 19, 2023, respectively. Compared to the 2022 predecessor, these two updates placed a particular emphasis on immunotherapy/targeted therapy, the introduction of NALIRIFOX regimen, and supplementary treatment protocols for patients with intermediate performance status. This article provided an interpretation of the latest updates to the NCCN clinical practice guidelines in oncology-pancreatic adenocarcinoma, integrating relevant evidence-based medical findings.

Cite this article

CHEN Jiahao , JIANG Chongyi . Interpretation of 2023 2nd NCCN clinical practice guidelines in oncology-pancreatic adenocarcinoma[J]. Journal of Surgery Concepts & Practice, 2024 , 29(01) : 10 -13 . DOI: 10.16139/j.1007-9610.2024.01.03

References

[1] OZONO Y, KAWAKAMI H, UCHIYAMA N, et al. Current status and issues in genomic analysis using EUS-FNA/FNB specimens in hepatobiliary-pancreatic cancers[J]. J Gastroenterol, 2023, 58(11):1081-1093.
[2] ASOKKUMAR R, YUNG KA C, LOH T, et al. Comparison of tissue and molecular yield between fine-needle biopsy (FNB) and fine-needle aspiration (FNA): a rando-mized study[J]. Endosc Int Open, 2019, 7(8):E955-E963.
[3] KANDEL P, NASSAR A, GOMEZ V, et al. Comparison of endoscopic ultrasound-guided fine-needle biopsy versus fine-needle aspiration for genomic profiling and DNA yield in pancreatic cancer: a randomized crossover trial[J]. Endoscopy, 2021, 53(4):376-382.
[4] NCCN Clinical Practice Guidelines in Oncology. Pancreatic adenocarcinoma (version 2.2023)[EB/OL].(2023-06-19)[2023-12-05]. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1455.
[5] GKOLFAKIS P, CRINò S F, TZIATZIOS G, et al. Comparative diagnostic performance of end-cutting fine-needle biopsy needles for EUS tissue sampling of solid pancreatic masses: a network meta-analysis[J]. Gastrointest Endosc, 2022, 95(6):1067-1077.
[6] COSTA B, VALE N. Dostarlimab: a review[J]. Biomo-lecules, 2022, 12(8):1031.
[7] CERCEK A, LUMISH M, SINOPOLI J, et al. PD-1 bloc-kade in mismatch repair-deficient, locally advanced rectal cancer[J]. N Engl J Med, 2022, 386(25):2363-2376.
[8] CHEN I M, JOHANSEN J S, THEILE S, et al. Rando-mized phase Ⅱ study of nivolumab with or without ipili-mumab combined with stereotactic body radiotherapy for refractory metastatic pancreatic cancer (CheckPAC)[J]. J Clin Oncol, 2022, 40(27):3180-3189.
[9] STRICKLER J H, SATAKE H, GEORGE T J, et al. Sotorasib in KRAS p.G12C-mutated advanced pancreatic cancer[J]. N Engl J Med, 2023, 388(1):33-43.
[10] BEKAII-SAAB T S, YAEGER R, SPIRA A I, et al. Adagrasib in advanced solid tumors harboring a KRASG12C mutation[J]. J Clin Oncol, 2023, 41(25):4097-4106.
[11] RAHMAN F A U, ALI S, SAIF M W. Update on the role of nanoliposomal irinotecan in the treatment of metastatic pancreatic cancer[J]. Therap Adv Gastroenterol, 2017, 10(7):563-572.
[12] NCCN Clinical Practice Guidelines in Oncology. Pancreatic adenocarcinoma (version 2.2022)[EB/OL].(2022-12-06)[2023-12-05]. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1455.
[13] WAINBERG Z A, MELISI D, MACARULLA T, et al. NALIRIFOX versus nab-paclitaxel and gemcitabine in treatment-naive patients with metastatic pancreatic ductal adenocarcinoma (NAPOLI 3): a randomised, open-label, phase 3 trial[J]. Lancet, 2023, 402(10409):1272-1281.
[14] WAINBERG Z A, BEKAII-SAAB T, BOLAND P M, et al. First-line liposomal irinotecan with oxaliplatin, 5-fluorouracil and leucovorin (NALIRIFOX) in pancreatic ductal adenocarcinoma: a phase Ⅰ/Ⅱ study[J]. Eur J Cancer, 2021,151:14-24.
[15] WANG-GILLAM A, LI C P, BODOKY G, et al. Nanoliposomal irinotecan with fluorouracil and folinic acid in metastatic pancreatic cancer after previous gemcitabine-based therapy (NAPOLI-1): a global, randomised, open-label, phase 3 trial[J]. Lancet, 2016, 387(10018):545-557.
[16] GHAZI R, ABIMANSOUR J P, MAHMOUD T, et al. Uncovered versus fully covered self-expandable metal stents for the management of distal malignant biliary obstruction[J]. Gastrointest Endosc, 2023, 98(4):577-584.
[17] ALMADI M A, BARKUN A, MARTEL M. Plastic vs. self-expandable metal stents for palliation in malignant biliary obstruction: a series of meta-analyses[J]. Am J Gastroenterol, 2017, 112(2):260-273.
[18] LI T T, SONG S L, XIAO L N, et al. Efficacy of fully co-vered self-expandable metal stents for the management of pancreatic duct strictures in chronic pancreatitis: a systematic review and meta-analysis[J]. J Gastroenterol Hepatol, 2020, 35(7):1099-1106.
[19] SOFI A A, KHAN M A, AHMAD S, et al. Comparison of clinical outcomes of multiple plastic stents and covered metal stent in refractory pancreatic ductal strictures in chronic pancreatitis- a systematic review and meta-analysis[J]. Pancreatology, 2021, 21(5):854-861.
Outlines

/