Pancreatic Adenocarcinoma: Advanced Unresectable and Metastatic Disease
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Alejandro Recio-Boiles, MD
Fellow, Division of Hematology and Medical Oncology, University of Arizona Cancer Center, Tucson, AZ

Hani M. Babiker, MD
Assistant Professor of Medicine, and Associate Director of Phase I Program, University of Arizona Cancer Center; Clinical Assistant Professor, Translational Genomics Research Institute, University of Arizona College of Medicine, Tucson, AZ

Question 1 of 5

A 62-year-old man with a history of anorexia and weight loss over the past 3 months presents with obstructive painless jaundice that has been present for the past 24 hours. In the emergency department, an abdominal multi-detector computed tomography (MDCT) scan identifies dilated common and intrahepatic bile ducts due to a 4.6 × 3.7 cm mass in the head of the pancreas and multifocal liver lesions, the largest of which is 2.7 cm in diameter. A biliary stent is placed via endoscopic retrograde cholangiopancreatography (ERCP), and forceps biopsy provides tissue confirmation of pancreatic adenocarcinoma. Findings from ultrasound-guided core biopsy of 1 of the liver lesions are consistent with metastatic pancreatic adenocarcinoma. The patient otherwise has excellent performance status with no medical comorbidities and desires treatment with the goals of prolonging his life and maintaining his quality of life. You are consulted for an opinion regarding the best possible treatment option.

Which of the following would not be an appropriate next step in the treatment of this patient?

Referral to palliative and hospice care for best supportive care alone

Enrollment in a clinical trial of first-line systemic therapy

Starting systemic therapy with gemcitabine

Starting systemic therapy with gemcitabine and nab-paclitaxel

Starting systemic therapy with fluorouracil plus leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX)

Hospital Physician: Hematology/Oncology. 2018 May;13(3)

This quiz is not accredited for CME.

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