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NCCN Guidelines for Patients



Pancreatic Cancer, Version 1.2017


Treatment guide

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.

First-line treatment

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.

Next steps

If first-line treatment doesn’t stop the cancer from

growing, see Guide 17 for second-line treatment