Which chemotherapy agents are used in the treatment of pancreatic cancer?

Updated: Jan 10, 2020
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

Antineoplastic agents and combinations of agents used in managing pancreatic carcinoma include the following:

  • Gemcitabine monotherapy: For symptomatic patients with metastatic or locally advanced unresectable disease with poor performance status [2]

  • GTX regimen (gemcitabine, docetaxel, capecitabine) [2]

  • Gemcitabine and albumin-bound paclitaxel [2]

  • FOLFIRINOX (LV5-FU [leucovorin/5-fluorouracil] plus oxaliplatin plus irinotecan): the National Comprehensive Cancer Network (NCCN) recommends this as first-line treatment for patients with metastatic or locally advanced unresectable disease with good performance status [2, 3]

  • Paclitaxel protein bound 125 mg/m2 plus gemcitabine 1000 mg/m2 IV over 30-40 min on Days 1, 8, and 15 of each 28-day cycle [4, 5]

  • 5-FU

  • Erlotinib plus gemcitabine

  • Capecitabine monotherapy or capecitabine plus erlotinib: May provide second-line therapy benefit in patient's refractory to gemcitabine [6]

Adjuvant therapy with gemcitabine is accepted as standard therapy for surgically resected pancreatic cancer. [7]  However, a study demonstrating markedly superior survival with modified FOLFIRINOX compared with gemcitabine in this setting promises to be practice changing. [8, 9] On the basis of this study, NCCN guidelines added modified FOLFIRINOX as a category 1, preferred adjuvant therapy regimen for patients with good performance status. [2]


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