NCCN Guidelines for Patients
Pancreatic Cancer, Version 1.2017
Treatment guide Locally advanced unresectable pancreatic cancer
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
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.
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