NCCN Guidelines for Patients
Pancreatic Cancer, Version 1.2017
Metastatic pancreatic cancer
Certain treatments and drug combinations have a
higher risk of severe, even lethal, side effects. Your
doctor should explain all of the risks and possible
side effects of the treatments you receive.
If you have a good performance status, then several
first-line treatment options may be considered. The
preferred option is to receive treatment within a
clinical trial. 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),
GTX (gemcitabine, docetaxel, and capecitabine),
FOLFOX (5-FU with oxaliplatin), gemcitabine with
nab-paclitaxel, or gemcitabine with erlotinib. Other
options include gemcitabine alone, or a different
gemcitabine-based combination regimen with
capecitabine or cisplatin.
If your performance status is poor, there are
two treatment options. One option is to receive
treatment with single agent chemotherapy 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
information on supportive care.
If first-line treatment doesn’t stop the cancer from
growing, see Guide 17 for second-line treatment