Chemotherapy for locally advanced and metastatic pancreatic cancer

Chemotherapy for locally advanced pancreatic cancer

Patients with locally advanced pancreatic cancer may be given chemotherapy to slow down the growth of cancer that has spread to nearby structures, such as the blood vessels around the pancreas. This may shrink the cancer and can also help with symptoms (1,2). Chemoradiotherapy may also be offered to patients with locally advanced disease.

For a small number of people, it may shrink the cancer enough to make surgery possible (3,4).

NICE guidelines recommend that combination chemotherapy should be considered for patients who are well enough to tolerate it and gemcitabine should be considered for those who aren’t well enough to tolerate combination chemotherapy (5).

Chemotherapy for metastatic pancreatic cancer

Patients with metastatic pancreatic cancer may be given chemotherapy to slow progression. Chemotherapy may help to control the cancer, and help with symptoms, though it won’t cure the cancer (6-11).

People with metastatic pancreatic cancer and an ECOG* performance status of 0 to 1 should be offered FOLFIRINOX (12).  Gemcitabine combination therapy should be considered for people who are not well enough to tolerate FOLFIRINOX, and single a

gent gemcitabine for those not well enough to tolerate combination chemotherapy (12).

*The ECOG Scale of Performance Status describes a patient’s level of functioning in terms of their ability to care for themselves, daily activity, and physical ability grades. The grades are from 0 – 5, with lower numbers reflecting better functional status. Grades and definitions are available at https://oncologypro.esmo.org/oncology-in-practice/practice-tools/performance-scales