Expert Perspectives: 55-Year-Old Woman Presenting With Locally Advanced Pancreatic Cancer: Next Steps

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This OncLive Insights program from ASCO 2025 features leading gastrointestinal medical oncologists discussing the latest advances in pancreatic cancer treatment. Tara E. Seery, MD, from the Hoag Family Cancer Institute; Paul E. Oberstein, MD, from NYU Langone; and Priyadarshini Pathak, MBBS, from Massachusetts General Hospital, present expert insights on clinical decision-making and updated trial data. The session begins with a comprehensive clinical case study of a 55-year-old female patient presenting with classic pancreatic cancer symptoms including weight loss, back pain, and jaundice.

The patient’s case demonstrates typical locally advanced pancreatic cancer presentation, featuring a 21-mm pancreatic head mass with portal vein invasion and bile duct obstruction requiring stent placement. Advanced imaging revealed a larger 3.5-cm tumor with adjacent lymph node involvement and possible gastric wall invasion, highlighting the challenges of accurate staging in pancreatic adenocarcinoma. This complex presentation exemplifies the multidisciplinary approach required for optimal pancreatic cancer management.

The clinical case sets the foundation for discussing treatment strategies in locally advanced pancreatic cancer, where surgical resection is not immediately feasible. The experts emphasize the importance of comprehensive staging, performance status assessment, and the role of systemic chemotherapy as first-line treatment. This case-based approach provides practical insights for oncologists managing similar challenging pancreatic cancer presentations in clinical practice.