Key points:

• The initial workup for newly diagnosed pancreatic cancer patients, including the importance of imaging and genetic testing.
• Treatment paradigms for early-stage, borderline resectable, and metastatic pancreatic cancer.
• The role of multi-agent chemotherapy, including modified FOLFIRINOX and gemcitabine + nab-paclitaxel.
• Insights into managing patients with high bilirubin levels and the considerations for dose adjustments.
• The emerging role of targeted therapies and the significance of comprehensive genetic testing in treatment decisions.
In this episode of the Oncology Brothers podcast, we had the privilege of speaking with Dr. Eileen O'Reilly, a leading medical oncologist specializing in pancreatic cancer at Memorial Sloan Kettering Cancer Center. We delved into the current treatment landscape for pancreatic cancer, starting with the initial workup for newly diagnosed patients. Dr. O'Reilly emphasized the importance of optimal imaging and comprehensive genetic testing, including germline testing for key mutations.
We explored the treatment paradigm for early-stage pancreatic cancer, particularly focusing on adjuvant therapy options like modified FOLFIRINOX for fit individuals. Dr. O'Reilly highlighted the significance of patient recovery and nutritional status before initiating treatment. We also discussed the management of borderline resectable disease, stressing the need for a multidisciplinary approach involving surgical and radiation oncology colleagues.
As we transitioned to metastatic pancreatic cancer, Dr. O'Reilly outlined the treatment options available, including modified FOLFIRINOX and gemcitabine-nab-paclitaxel, while also addressing the role of genetic testing for actionable mutations. We touched on the challenges of managing patients with high bilirubin levels and the considerations for subsequent treatment lines after disease progression.
Finally, we discussed the emerging role of PARP inhibitors in patients with specific genetic profiles, emphasizing their use as a maintenance therapy after platinum-based treatments. Throughout the episode, Dr. O'Reilly provided valuable insights into the complexities of managing pancreatic cancer and the importance of personalized treatment strategies.
We hope you find this discussion informative and insightful as we continue to explore the evolving landscape of oncology. Thank you for joining us, and be sure to check out our other episodes for more on recent developments in cancer treatment.