SEOM clinical guidelines for pancreatic and biliary tract cancer (2020)

作者：Ma A. Gómez-España, Ana Fernández Montés, Rocio García‐Carbonero, Teresa Macarulla Mercade, Joan Maurel, Ágatha Martín, Roberto Pazo-Cid, Ruth Vera, Alfredo Carrato, Jaime Feliú · 发表于：Clinical & Translational Oncology · 年份：2021 · DOI：10.1007/s12094-021-02573-1 · 被引用次数：48 · 研究领域：Cholangiocarcinoma and Gallbladder Cancer Studies、Pancreatic and Hepatic Oncology Research、Gallbladder and Bile Duct Disorders

Pancreatic cancer (PC) and biliary tract cancer (BTC) are both aggressive and highly fatal malignancies. Nowadays we have a profound knowledge about the molecular landscape of these neoplasms and this has allowed new therapeutic options. Surgery is the only potentially curative therapy in both cancers, but disease recurrence is frequent. In PC, adjuvant treatment with mFOLFIRINOX has improved overall survival (OS) and in BTC adjuvant treatment with capecitabine seems to improve OS and relapse-free survival. Concomitant radio-chemotherapy could also be considered following R1 surgery in both neoplasms. Neoadjuvant treatment represents the best option for achieving an R0 resection in borderline PC. Upfront systemic chemotherapy is the treatment of choice in unresectable locally advanced PC and BTC; then locoregional therapy could be considered after an initial period of at least 3-4 months of systemic chemotherapy. In metastatic PC, FOLFIRINOX or Gemcitabine plus nab-paclitaxel have improved OS compared with gemcitabine alone. In metastatic BTC, cisplatin plus gemcitabine constitute the standard treatment. Progress in the knowledge of molecular biology has enabled the identification of new targets for therapy with encouraging results that could in the future improve the survival and quality of life of patients with PC and BTC.