Expert opinion on management of pancreatic exocrine insufficiency in pancreatic cancer.

G Roeyen, F Berrevoet, I Borbath, K Geboes, M Peeters, B Topal, E Van Cutsem, J-L Van Laethem

Journal: ESMO open 2022;7(1):100386

PMID: 35124465

Free Full Text on Elsevier Science View on PubMed

Abstract

Pancreatic exocrine insufficiency (PEI) is a common condition in patients with pancreatic cancer (PC). PEI can be due to the tumor, which, if located in the head, causes obstruction of the pancreatic duct with subsequent atrophy of the pancreatic parenchyma, or it can be the consequence of pancreatic surgical resection. The standard treatment of PEI is pancreatic enzyme replacement therapy (PERT). Clinical data to support the use of PERT in PC are however limited. There are very few randomized clinical trials that evaluated PERT in PC. Most data come from observational studies. Despite this limited clinical evidence, PERT treatment for PEI is an essential part of supportive therapy to ensure optimal nutritional status in PC patients who will receive surgery, neoadjuvant/adjuvant or palliative treatment. The objective of this review is to increase the awareness about PEI in PC patients and to provide expert recommendations on the use of PERT in resected, borderline resectable and unresectable patients, based on clinical experience and literature review.

Address: Department of Hepatobiliary Transplantation and Endocrine Surgery, Antwerp University Hospital and University of Antwerp, Edegem. Electronic address: [email protected].; Department of General and Hepatobiliary Surgery, Ghent University Hospital, Ghent.; Hepato-Gastroenterology Unit, Cliniques Universitaires Saint-Luc, Brussels.; Department of Gastroenterology, Division of Digestive Oncology, Ghent University Hospital, Ghent.; Department of Oncology, Antwerp University Hospital and University of Antwerp, Edegem.; Department of Visceral Surgery, University Hospitals KU Leuven, Leuven.; Department of Gastroenterology/Digestive Oncology, University Hospital Leuven, University Hospitals Gasthuisberg Leuven and KU Leuven, Leuven.; Department of Digestive Oncology, University Hospital Erasmus Brussels, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.

DOI: 10.1016/j.esmoop.2022.100386

Link outs

Free resources

Full Text Sources:

Medical:

https://medlineplus.gov/pancreaticcancer.html

Subscription / membership required

Full Text Sources:

https://www.clinicalkey.com/content/playBy/pii?v=S...

MeSH Terms: Enzyme Replacement Therapy, Exocrine Pancreatic Insufficiency, Humans, Pancreas, Pancreatic Neoplasms