Metastatic Pancreatic Cancer: The Dilemma of Quality vs. Quantity of Life

  • Armin Shahrokni University of California. Los Angeles, CA, USA
  • Muhammad Wasif Saif Tufts University School of Medicine. Boston, MA, USA
Keywords: Palliative Care, Pancreatic Neoplasms, Quality of Life


Due to pancreatic cancer’s dismal prognosis, much of management is focused upon palliation and symptom management, and the decision to treat a patient with more aggressive maneuvers must always take into account the impact upon a patient’s quality of life. In addition, majority of the patients with advanced pancreatic cancer are elderly. Oncologists are challenged to make tough treatment decisions. Many elderly patients cannot tolerate side effects of chemotherapy, especially the combination regimens. Despite that many patients continue to receive chemotherapy even in the last month of their lives. The effect of referral to palliative care on health-related outcome especially for patients with poor quality of life is still not very clear. The authors will review abstracts that have focused on these fields that were presented at the Annual Meeting of ASCO 2013 (Abstracts #4009, #4053, #6607, #9518, #9538, #9539, #9546, and #9638).

Image: University of California Medical Center. Los Angeles, CA, USA.


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Author Biographies

Armin Shahrokni, University of California. Los Angeles, CA, USA
Clinical Fellow, UCLA Geriatric Oncology Program
Muhammad Wasif Saif, Tufts University School of Medicine. Boston, MA, USA
Director of GI Oncology Program , Tufts Medical Center


Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012; 62:10-29.

Lau MK, Davila JA, Shaib YH. Incidence and survival of pancreatic head and body and tail cancers: a population-based study in the United States. Pancreas. 2010; 39:458-62.

Tempero MA, Arnoletti JP, Behrman SW, et al. Pancreatic Adenocarcinoma, version 2.2012: featured updates to the NCCN Guidelines. J Natl Compr Canc Netw. 2012; 10:703-13.

Shaib YH, Davila JA, El-Serag HB. The epidemiology of pancreatic cancer in the United States: changes below the surface. Aliment Pharmacol Ther. 2006; 24:87-94.

Oberstein PE, Hershman DL, Khanna LG, Chabot JA, Insel BJ, Neugut AI. Uptake and patterns of use of gemcitabine for metastatic pancreatic cancer: a population-based study. Cancer Invest. 2013; 31:316-22.

Sun C, Ansari D, Andersson R, Wu DQ. Does gemcitabine-based combination therapy improve the prognosis of unresectable pancreatic cancer? World J Gastroenterol. 2012; 18:4944-58.

Vijayvergia N, Dotan E, Devarajan K, Hatahet K, Rahman F, Cohen S. Differences in patterns of care and outcomes of elderly versus younger metastatic pancreatic cancer (mPC) patients., J Clin Oncol 31, 2013 (suppl; abstr #9546).

Cartwright T, Arlen A, Wilfong L, Harrell R, Hoverman J, Beveridge R. Updated use of first-line chemotherapy for advanced pancreatic cancer: FOLFIRINOX versus gemcitabine., J Clin Oncol 31, 2013 (suppl; abstr #6607).

Strumberg D, Schultheis B, Ebert M, Kerkhoff A, Hofheinz R, Behringer D. Phase II, randomized, double-blind placebo-controlled trial of nimotuzumab plus gemcitabine compared with gemcitabine alone in patients (pts) with advanced pancreatic cancer (PC. J Clin Oncol 31, 2013 (suppl; abstr #4009).

Sheffield KM, Boyd CA, Benarroch-Gampel J, Kuo YF, Cooksley CD, Riall TS. End-of-life care in Medicare beneficiaries dying with pancreatic cancer. Cancer. 2011; 117:5003-12.

Rodriguez MA, DeJesus YA, Cheng L, Buzdar A, Burke TW. Factors related to end-of-life (EOL) chemotherapy in solid tumor (ST) patients. J Clin Oncol 31, 2013 (Suppl.): Abstract #9538.

Burke T, DeJesus Y, Cheng L, Buzdar A, MA R. Pattern of chemotherapy use at end-of-life (EOL) in patients with solid tumors (ST). J Clin Oncol 31, 2013 (suppl; abstr #9539).

Jang R, Krzyzanowska M, Zimmermann C, Taback N, Alibhai S. Intensity of palliative care and its impact on the aggressiveness of end-of-life care in patients with advanced pancreatic cancer., J Clin Oncol 31, 2013 (suppl; abstr #9518.

Aktas A, Walsh D, Rybicki L, Fitz, A, Horvitz H. Symptom clusters and demographic characteristics in advanced cancer., J Clin Oncol 31, 2013 (suppl; abstr #9638).

Vickers M, Tu D, Lee C, Price P, Parulekar W, Brundage M. Significance of baseline quality of life scores in predicting clinical outcomes in an international phase III trial of advanced pancreatic cancer: NCIC CTG PA.3. J Clin Oncol 31, 2013 (suppl; abstr #4053).

Conroy T, Desseigne F, Ychou M, et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med. 2011; 364:1817-25.

Gourgou-Bourgade S, Bascoul-Mollevi C, Desseigne F, et al. Impact of FOLFIRINOX compared with gemcitabine on quality of life in patients with metastatic pancreatic cancer: results from the PRODIGE 4/ACCORD 11 randomized trial. J Clin Oncol. 2013; 31:23-9.

Conroy T, Gavoille C, Adenis A. Metastatic pancreatic cancer: old drugs, new paradigms. Curr Opin Oncol. 2011; 23:390-5.

Hurria A, Togawa K, Mohile SG, et al. Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study. J Clin Oncol. 2011; 29:3457-65.

Temel JS, Greer JA, Muzikansky A, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010; 363:733-42.

Epstein AS, Abou-Alfa GK, Shamseddine A, et al. Communication and palliative care in a 64-year-old man with pancreatic adenocarcinoma. Gastrointest Cancer Res. 2012; 5:130-4.

Panagiotarakou M, Gupta A, Syrigos K, Saif MW. Use of supportive care for symptom management in pancreatic cancer: application of clinical research to patient care. JOP. 2012; 13:342-4.

Saif MW. Palliative care of pancreatic cancer. Highlights from the "2011 ASCO Annual Meeting". Chicago, IL, USA; June 3-7, 2011. JOP. 2011; 12:355-7.

Frigeri M, De Dosso S, Castillo-Fernandez O, Feuerlein K, Neuenschwander H, Saletti P. Chemotherapy in patients with advanced pancreatic cancer: too close to death? Support Care Cancer. 2013; 21:157-63.

Quinten C, Coens C, Mauer M, et al. Baseline quality of life as a prognostic indicator of survival: a meta-analysis of individual patient data from EORTC clinical trials. Lancet Oncol. 2009; 10:865-71.

Romanus D, Kindler HL, Archer L, et al. Does health-related quality of life improve for advanced pancreatic cancer patients who respond to gemcitabine? Analysis of a randomized phase III trial of the cancer and leukemia group B (CALGB 80303). J Pain Symptom Manage. 2012; 43:205-17.

University of California Medical Center. Los Angeles, CA, USA
How to Cite
ShahrokniA., & SaifM. (2013). Metastatic Pancreatic Cancer: The Dilemma of Quality vs. Quantity of Life. JOP. Journal of the Pancreas, 14(4), 391-394.
Highlights from the “2013 ASCO Annual Meeting”. Chicago, IL, USA. May 31 - June 4, 2013

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