The National Comprehensive Cancer Network (NCCN) has released their latest guidelines for the treatment of pancreatic adenocarcinoma, featuring a new therapy in the second-line setting.
An initial NCCN guideline update of 2017 for pancreatic adenocarcinoma included many changes to available surveillance, chemotherapy, and radiation options. The latest update adds another second-line therapy option for patients with a specific subset of disease.
As a second-line therapy for locally advanced, unresectable, metastatic pancreatic cancer with good performance status, pembrolizumab was added for disease previously treated with gemcitabine-based therapy or fluoropyrimidine-based therapy. The new indication for pembrolizumab applies only to microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) tumors.
Additionally, the guideline suggests considering microsatellite instability testing and/or mismatch repair testing on adenocarcinoma-confirmed or metastatic tumor tissue.—Zachary Bessette