George P. Kim, MD: Aligning Treatment With Updates in NCCN Guidelines

How would Henry's treatment course align with the recent updates to the NCCN guidelines?

Metastatic Pancreatic Cancer: Case 2

Henry R was diagnosed with adenocarcinoma in the body of the pancreas when he was 64 years old, following rapid weight loss, abdominal pains, and the development of venous thrombosis.

• At diagnosis, measurable distant lymph node, liver, and lung metastases were observed
• His CA19-9 level was 2760 U/ml and his concentration of albumin was 28 g/L. His ECOG performance status was 1.

Upfront treatment was administered with nab-paclitaxel and gemcitabine, which lasted for 4months:

• At the time of progression, pain levels had increased interfering with daily activity and raising the ECOG performance status to a 2.
• At this point, second-line therapy was initiated with liposomal irinotecan, fluorouracil, and folinic acid.