What are the ASCO guidelines for initial assessment of metastatic pancreatic cancer?

Updated: Oct 02, 2020
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

In patients diagnosed with metastatic pancreatic cancer, American Society of Clinical Oncology (ASCO) guidelines recommend the following as part of the initial assessment [95] :

  • Perform a multiphase CT scan of the chest, abdomen, and pelvis to assess the extent of disease. Perform other staging studies only as dictated by symptoms.
  • Evaluate the patient’s baseline performance status (PS), symptom burden, and comorbidity profile.
  • Discuss the goals of care (including an advance directive), patient preferences, and support systems.

Multidisciplinary collaboration to formulate treatment and care plans and disease management should be the standard of care.

Early testing for actionable genomic alterations is recommended to guide treatment decisions for patients who are likely to be potential candidates for additional treatment after first-line therapy. Both germline and somatic testing for the following are recommended:

  • Microsatellite instability (MSI)/mismatch repair deficiency (dMMR)
  • BRCA mutations with known significance
  • NTRK gene fusions

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