TY - JOUR
T1 - Pancreas Cancer-Associated Weight Loss
AU - on behalf of the Precision Promise Consortium
AU - Hendifar, Andrew E.
AU - Petzel, Maria Q.B.
AU - Zimmers, Teresa A.
AU - Denlinger, Crystal S.
AU - Matrisian, Lynn M.
AU - Picozzi, Vincent J.
AU - Rahib, Lola
AU - Hendifar, Andrew
AU - Tuli, Richard
AU - Wolpin, Brian
AU - Hidalgo, Manuel
AU - Ryan, David
AU - Hingorani, Sunil
AU - Chiorean, Elena Gabriela
AU - Coveler, Andrew
AU - O'Reilly, Eileen
AU - Balachandran, Vinod
AU - Simeone, Diane
AU - Lowy, Andrew
AU - Fanta, Paul
AU - Kurzrock, Razelle
AU - Reid, Tony
AU - Ko, Andrew
AU - Collisson, Eric
AU - Tempero, Margaret
AU - Kindler, Hedy
AU - George, Thomas
AU - Trevino, Jose
AU - Vonderheide, Robert
AU - Beatty, Gregory
AU - Picozzi, Vincent
AU - Mandelson, Margaret
AU - Wang-Gillam, Andrea
AU - Hawkins, William
AU - Fleshman, Julie
AU - Hidalgo, Manuel
AU - Hingorani, Sunil
AU - Maitra, Anirban
AU - Manax, Victoria
AU - Matrisian, Lynn
AU - Picozzi, Vincent
AU - Simeone, Diane
N1 - Funding Information:
We thank Merle Witter for assistance of the preparation of the manuscript. This work was supported by the Pancreatic Cancer Action Network, NIH grants R01 CA122596 and R01 CA194593, the Lustgarten Foundation, Veterans Administration Merit Award I01 BX004177, and the Lilly Endowment, Inc. At the time this manuscript was written, The Precision Promise Consortium was composed of the following members: Andrew Hendifar, Principal Investigator; Richard Tuli, Co-PI (Cedars-Sinai Medical Center); Brian Wolpin, Principal Investigator; Manuel Hidalgo; David Ryan (Dana Farber/Harvard Cancer Center); Sunil Hingorani, Principal Investigator; Elena Gabriela Chiorean; Andrew Coveler (Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance/University of Washington); Eileen O'Reilly, Principal Investigator; Vinod Balachandran (Memorial Sloan Kettering Cancer Center); Diane Simeone (Perlmutter Cancer Center/NYU Langone Health); Andrew Lowy, Principal Investigator; Paul Fanta; Razelle Kurzrock; Tony Reid (University of California, San Diego); Andrew Ko, Principal Investigator; Eric Collisson; Margaret Tempero (University of California, San Francisco); Hedy Kindler, Principal Investigator (University of Chicago); Thomas George, Principal Investigator; Jose Trevino (University of Florida); Robert Vonderheide, Principal Investigator; Gregory Beatty (University of Pennsylvania); Vincent Picozzi, Principal Investigator; Margaret Mandelson (Virginia Mason Medical Center); Andrea Wang-Gillam, Principal Investigator; William Hawkins (Washington University); and the Precision Promise Steering Committee (Julie Fleshman, Pancreatic Cancer Action Network; Manuel Hidalgo, Dana Farber Cancer Institute; Sunil Hingorani, Fred Hutchinson Cancer Research Center; Anirban Maitra, MD Anderson Cancer Center; Victoria Manax, Pancreatic Cancer Action Network; Lynn Matrisian, Pancreatic Cancer Action Network; Vincent Picozzi, Virginia Mason Medical Center; Diane Simeone, Perlmutter Cancer Center/NYU Langone Health).
Funding Information:
We thank Merle Witter for assistance of the preparation of the manuscript. This work was supported by the Pancreatic Cancer Action Network, NIH grants R01 CA122596 and R01 CA194593, the Lustgarten Foundation, Veterans Administration Merit Award I01 BX004177, and the Lilly Endowment, Inc. At the time this manuscript was written, The Precision Promise Consortium was composed of the following members: Andrew Hendifar, Principal Investigator; Richard Tuli, Co-PI (Cedars-Sinai Medical Center); Brian Wolpin, Principal Investigator; Manuel Hidalgo; David Ryan (Dana Farber/Harvard Cancer Center); Sunil Hingorani, Principal Investigator; Elena Gabriela Chiorean; Andrew Coveler (Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance/University of Washington); Eileen O’Reilly, Principal Investigator; Vinod Balachandran (Memorial Sloan Kettering Cancer Center); Diane Simeone (Perlmutter Cancer Center/NYU Langone Health); Andrew Lowy, Principal Investigator; Paul Fanta; Razelle Kurzrock; Tony Reid (University of California, San Diego); Andrew Ko, Principal Investigator; Eric Collisson; Margaret Tempero (University of California, San Francisco); Hedy Kindler, Principal Investigator (University of Chicago); Thomas George, Principal Investigator; Jose Trevino (University of Florida); Robert Vonderheide, Principal Investigator; Gregory Beatty (University of Pennsylvania); Vincent Picozzi, Principal Investigator; Margaret Mandel-son (Virginia Mason Medical Center); Andrea Wang-Gillam, Principal Investigator; William Hawkins (Washington University); and the Precision Promise Steering Committee (Julie Fleshman, Pancreatic Cancer Action Network; Manuel Hidalgo, Dana Farber Cancer Institute; Sunil Hingorani, Fred Hutchinson Cancer Research Center; Anirban Maitra, MD Anderson Cancer Center; Victoria Manax, Pancreatic Cancer Action Network; Lynn Matrisian, Pancreatic Cancer Action Network; Vincent Picozzi, Virginia Mason Medical Center; Diane Simeone, Perlmutter Cancer Center/NYU Langone Health).
Publisher Copyright:
© AlphaMed Press 2018
PY - 2019/5
Y1 - 2019/5
N2 - Unintentional weight loss in patients with pancreatic cancer is highly prevalent and contributes to low therapeutic tolerance, reduced quality of life, and overall mortality. Weight loss in pancreatic cancer can be due to anorexia, malabsorption, and/or cachexia. Proper supportive care can stabilize or reverse weight loss in patients and improve outcomes. We review the literature on supportive care relevant to pancreatic cancer patients, and offer evidence-based recommendations that include expert nutritional assessment, counseling, supportive measures to ensure adequate caloric intake, pancreatic enzyme supplementation, nutritional supplement replacement, orexigenic agents, and exercise. Pancreatic Cancer Action Network-supported initiatives will spearhead the dissemination and adoption of these best supportive care practices. Implications for Practice: Weight loss in pancreatic cancer patients is endemic, as 85% of pancreatic cancer patients meet the classic definition of cancer cachexia. Despite its significant prevalence and associated morbidity, there is no established approach to this disease entity. It is believed that this is due to an important knowledge gap in understanding the underlying biology and lack of optimal treatment approaches. This article reviews the literature regarding pancreas cancer-associated weight loss and establishes a new framework from which to view this complex clinical problem. An improved approach and understanding will help educate clinicians, improve clinical care, and provide more clarity for future clinical investigation.
AB - Unintentional weight loss in patients with pancreatic cancer is highly prevalent and contributes to low therapeutic tolerance, reduced quality of life, and overall mortality. Weight loss in pancreatic cancer can be due to anorexia, malabsorption, and/or cachexia. Proper supportive care can stabilize or reverse weight loss in patients and improve outcomes. We review the literature on supportive care relevant to pancreatic cancer patients, and offer evidence-based recommendations that include expert nutritional assessment, counseling, supportive measures to ensure adequate caloric intake, pancreatic enzyme supplementation, nutritional supplement replacement, orexigenic agents, and exercise. Pancreatic Cancer Action Network-supported initiatives will spearhead the dissemination and adoption of these best supportive care practices. Implications for Practice: Weight loss in pancreatic cancer patients is endemic, as 85% of pancreatic cancer patients meet the classic definition of cancer cachexia. Despite its significant prevalence and associated morbidity, there is no established approach to this disease entity. It is believed that this is due to an important knowledge gap in understanding the underlying biology and lack of optimal treatment approaches. This article reviews the literature regarding pancreas cancer-associated weight loss and establishes a new framework from which to view this complex clinical problem. An improved approach and understanding will help educate clinicians, improve clinical care, and provide more clarity for future clinical investigation.
KW - Anorexia
KW - Cachexia
KW - Malabsorption
KW - Pancreatic cancer
KW - Supportive care
KW - Weight loss
UR - http://www.scopus.com/inward/record.url?scp=85059139109&partnerID=8YFLogxK
U2 - 10.1634/theoncologist.2018-0266
DO - 10.1634/theoncologist.2018-0266
M3 - Review article
C2 - 30591550
AN - SCOPUS:85059139109
SN - 1083-7159
VL - 24
SP - 691
EP - 701
JO - Oncologist
JF - Oncologist
IS - 5
ER -