NCCN Guidelines for Patients® | Pancreatic Cancer - page 73

NCCN Guidelines for Patients
Pancreatic Cancer, Version 1.2014
Treatment guide
Metastatic pancreatic cancer
Second-line treatment
If you have a good health status after first-
line treatment,
there are four main options for
second-line treatment. 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. (Read Part 3 on
page 30 for details on clinical trials.) 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 that wasn’t helped by pain
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
palliative and supportive care available. Supportive
care—also called palliative care—is treatment for
the symptoms and health conditions caused by
pancreatic cancer. The other option is to join a clinical
If you have a poor health status after first-line
then palliative and best supportive care
is recommended. Read Part 4 on page 36 for more
details about supportive care.
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