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NCCN Guidelines for Patients



Pancreatic Cancer, Version 1.2017


Treatment guide Locally advanced unresectable pancreatic cancer

First-line treatment

If you have a good performance status, then there

are several first-line treatment options. The preferred

option is to receive treatment within a clinical trial.

A clinical trial is a type of research that studies the

safety and effectiveness of a test or treatment. Your

other options are chemotherapy drugs that have

been tested in clinical trials.

The other options include using various

chemotherapy regimens such as: FOLFIRINOX (5-

FU, leucovorin, irinotecan, and oxaliplatin), a GTX

(gemcitabine, docetaxel, and capecitabine), FOLFOX

(5-FU, leucovorin, and oxaliplatin), gemcitabine

alone, capecitabine alone, continuous infusion

5-FU alone, or gemcitabine with nab-paclitaxel.

Other options include a different gemcitabine-based

combination regimen with capecitabine, cisplatin,

or erlotinib. Following any of these chemotherapy

options, you may receive chemoradiation or SBRT if

there is no cancer growth for months and no signs of

distant metastases.

If your peformance status is poor, there are two

treatment options. One option is to receive one

chemotherapy agent alone such as gemcitabine,

capecitabine, or continuous 5-FU. The other option is

to receive the best supportive care. Supportive care,

also called palliative care, is a treatment focused on

symptom control and improvement of quality of life.

See Part 4 for more on supportive care.

Next steps

If first-line treatment doesn’t stop cancer

growth, see Guide 15 for second-line treatment

recommendations. If the cancer spreads far from

the first tumor, see the metastatic pancreatic cancer

treatment recommendations.