title: Update on the Management of Pancreatic Cancer in Older Adults.
abstract: Pancreatic cancer is more common in older adults, who are underrepresented in clinical trials and frequently under treated. Chronological age alone should not deter clinicians from offering treatment to geriatric patients, as they are a heterogeneous population. Geriatric assessment, frailty assessment tools, and toxicity risk scores help clinicians select appropriate patients for therapy. For resectable disease, surgery can be safe but should be done at a high-volume center. Adjuvant therapy is important; though there remains controversy on the role of radiation, chemotherapy is well studied and efficacious. In locally advanced unresectable disease, chemoradiation or chemotherapy alone is an option. Neoadjuvant therapy improves the chances of resectability in borderline resectable disease. Chemotherapy extends survival in metastatic disease, but treatment goals and risk-benefit ratios have to be clarified. Adequate symptom management and supportive care are important. There are now many new treatment strategies and novel therapies for this disease.
authors: Section of Hematology/Oncology, Boston University School of Medicine, Boston Medical Center, 820 Harrison Avenue, Boston, MA, 02118, USA. shinyin.lee@bmc.org.
authors: Shin Yin
authors: SY
authors: Lee
authors: Charleston Area Medical Center Cancer Center, 3415 MacCorkle Avenue, SE, Charleston, WV, 25304, USA.
authors: Moussa
authors: M
authors: Sissoko
authors: Section of Hematology/Oncology, Boston University School of Medicine, Boston Medical Center, 820 Harrison Avenue, Boston, MA, 02118, USA.
authors: Kevan L
authors: KL
authors: Hartshorn
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D020360:Neoadjuvant Therapy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000628:therapy*; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011379:Prognosis; D018570:Risk Assessment; D015996:Survival Rate
keywords: Chemoradiation; Chemotherapy; Comprehensive geriatric assessment; Frailty scores; Geriatric oncology; Novel therapies; Older adults; Pancreatic adenocarcinoma; Radiation; Surgery; Symptom management; Toxicity scores; Update