Pancreatic adenocarcinoma is currently treated with surgery, chemotherapy, radiation therapy, immunotherapy, targeted therapy, supportive therapy, or a combination of these therapies.1 Although maintenance therapy is a relatively new concept in pancreatic cancer, it has been used to treat patients with other serious diseases, including ovarian cancer.2
Maintenance therapy may use chemotherapy, hormone therapy, or targeted therapy medications, and treatment usually involves just 1 medication at a time. Therefore, side effects are typically fewer with maintenance therapy compared with traditional chemotherapy used for first-line treatment.3
Maintenance therapy is used to prevent or delay the return of cancer for patients in remission or to slow the growth of advanced cancers after a first treatment.3 An important goal of maintenance therapy is to use medications that do not cause major side effects so that patients can keep a good quality of life during this treatment.2 It is also important that medications for maintenance therapy be easy to take and convenient.4
Maintenance therapy may be a way to treat patients so that pancreatic cancer becomes more like a chronic disease, and patients can live longer and better.4 The aim of maintenance therapy is to give patients a break from traditional chemotherapy and its side effects so that they can have a good quality of life.4
No medications for maintenance therapy are currently approved in pancreatic cancer. However, several trials are currently recruiting patients to participate in maintenance therapy.5
Does Maintenance Therapy Work in Clinical Trials?
Outcomes from early clinical trials of maintenance therapy in pancreatic cancer are promising.
One recent study included patients with metastatic pancreatic cancer who had a BRCA1 or BRCA2 mutation.2 These patients had already received a first round of chemotherapy and their disease was stable. Patients who received maintenance therapy had a longer period of time during which their disease did not progress compared with those who did not receive maintenance therapy.2
The patients who received maintenance therapy were also able to preserve their quality of life during treatment.2 Maintenance therapy has fewer side effects than chemotherapy, and patients receiving maintenance therapy had a similar quality of life compared with patients who received no treatment during the study.2,6
Quality of Life
Maintenance therapy is one promising way healthcare providers may be able to help patients maintain a good quality of life during pancreatic cancer treatment. However, quality of life should be a priority throughout a patient’s journey with pancreatic cancer. It is important that patients speak with their healthcare providers and loved ones about symptoms, treatment side effects, and concerns.7 When choosing treatments, patients and healthcare providers should consider both the expected disease outcomes and the expected effects on patients’ quality of life.6
Symptoms, such as pain and fatigue, and treatment side effects can have a big impact on how patients feel from day to day.6 Quality of life can also be affected by emotional and practical concerns.7 Supportive care can help patients have less severe pain and other symptoms, better quality of life, and improved emotional health.8
- Pancreatic Cancer Action Network. Treatment types. www.pancan.org/facing-pancreatic-cancer/treatment/treatment-types. 2019. Accessed November 14, 2019.
- Golan T, Hammel P, Reni M, et al. Maintenance olaparib for germline BRCA-mutated metastatic pancreatic cancer. N Engl J Med. 2019;381:317-327.
- Cancer.Net. Understanding maintenance therapy. www.cancer.net/navigating-cancer-care/how-cancer-treated/understanding-maintenance-therapy. May 2019. Accessed November 14, 2019.
- Picozzi V. What is the future role of maintenance therapy in pancreatic cancer? Partners in Pancreatic Cancer. www.partnersinpancreaticcancer.com/reference-ppc/faq-ppc/296-what-is-the-future-role-of-maintenance-therapy-in-pancreatic-cancer. July 25, 2018. Accessed November 21, 2019.
- ClinicalTrials.gov [database online]. Bethesda, MD: US National Library of Medicine. https://clinicaltrials.gov/ct2/results?cond=Pancreatic+Cancer&term=maintenance&cntry=&state=&city=&dist=&recrs=a&recrs=d. Accessed November 14, 2019.
- Hammel P, Kindler HL, Reni M, et al. Health-related quality of life in patients with a germline BRCA mutation and metastatic pancreatic cancer receiving maintenance olaparib. Ann Oncol. 2019 Sep 28. pii: mdz406. doi: 10.1093/annonc/mdz406. [Epub ahead of print].
- Pancreatic Cancer Action Network. Managing side effects. www.pancan.org/facing-pancreatic-cancer/living-with-pancreatic-cancer/managing-side-effects-palliative-care. 2019. Accessed November 14, 2019.
- American Cancer Society. Who should get palliative care and why? www.cancer.org/treatment/treatments-and-side-effects/palliative-care/who-should-get-palliative-care.html. Last revised May 10, 2019. Accessed November 15, 2019.