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58

NCCN Guidelines for Patients

®

:

Pancreatic Cancer, Version 1.2017

5

Treatment guide

Metastatic pancreatic cancer

Guide 17

shows the second-line treatment options

recommended for metastatic pancreatic cancer.

Second-line treatment is the next set of treatments

given when the first or previous treatments failed to

stop cancer growth.

Performance status rating

Which treatment is recommended for you depends

on your health status rating, also called performance

status. Your performance status is a rating by

your doctor based on your overall health, cancer

symptoms, and ability to do daily activities. Your

doctor will rate your performance status again after

first-line treatment to decide which option is best to

give you next.

Guide 17. Second-line treatment

Performance

status rating First-line treatment Second-line treatment

Good

performance

status and

disease

progression

ª

• Had gemcitabine-

based

chemotherapy

ª

• Clinical trial

(preferred)

or

• Fluoropyrimidine

based-chemotherapy

or

• Radiation for severe

pain (pain meds aren’t

working)

ª

• Palliative

and best

supportive

care

or

• Clinical trial

ª

• Had

fluoropyrimidine-

based

chemotherapy

ª

• Clinical trial

(preferred)

or

• Gemcitabine-based

chemotherapy

or

• 5-FU with leucovorin,

and irinotecan

liposome injection (if

not given irinotecan

before)

or

• Radiation for severe

pain (pain meds aren’t

working)