What are the ASCO guidelines on first-line treatment of metastatic pancreatic cancer?

Updated: Oct 02, 2020
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
  • Print
Answer

For first-line treatment of metastatic pancreatic cancer, ASCO guidelines recommend FOLFIRINOX (leucovorin, fluorouracil, irinotecan, and oxaliplatin) for patients who meet all of the following criteria [98, 95] :

Gemcitabine plus nab-paclitaxel is recommended for patients who meet all of the following criteria:

  • ECOG performance status  0-1
  • Relatively favorable comorbidity profile
  • Patient preference and a support system for relatively aggressive medical therapy 

Gemcitabine alone is recommended for patients who have either an ECOG performance status of 2 or a comorbidity profile that precludes more aggressive regimens and for patients who wish to pursue cancer-directed therapy. The addition of nab-paclitaxel or capecitabine or erlotinib to gemcitabine may be offered, with proactive dose and schedule adjustments to minimize toxicities.

In patients with an ECOG performance status of 3 or with poorly controlled comorbid conditions despite ongoing active medical care, cancer-directed therapy should be offered only on a case-by-case basis. Major emphasis should be on optimizing supportive care measures. 


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!