NCCN Guidelines for Patients
Pancreatic Cancer, Version 1.2017
If you have a good performance status after first-
line treatment, there are 4 main options for second-
line treatment. The preferred option is to receive
treatment within a clinical trial. The next two options
depend on the type of chemotherapy you had before.
Fluoropyrimidine-based chemotherapy is an option
if you had a gemcitabine-based regimen before.
Likewise, gemcitabine-based therapy is an option if
you had a fluoropyrimidine-based regimen before.
Lastly, radiation therapy may be given if you have
severe pain not helped by pain medications.
If second-line treatment doesn’t stop the cancer
from growing or spreading, then you have two more
treatment options. One 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. The other
option is to join a clinical trial.
If you have a poor performance status after
first-line treatment, then best supportive care is
recommended. See Part 4 for more information on
Cancer tests are used to find cancer, plan
treatment, and check how well treatment is
When cancer is only in the pancreas, surgery
may be a treatment option.
If you have a borderline resectable pancreatic
cancer, your doctor may plan to give you
treatment before surgery. This is called
First-line treatment is the first treatment or set
of treatments given to control the cancer.
Second-line treatment is the next set of
treatments given when the first or previous
treatments failed to stop cancer growth.
Before beginning treatment for the cancer, your
doctor will first give treatment for symptoms
such as jaundice.
Your performance status rating is a very
important factor when choosing the best
treatment for you.