Video

Dr. Chung on Sequencing Chemotherapy Regimens in Metastatic Pancreatic Cancer

Vincent Chung, MD, associate clinical professor, Department of Medical Oncology and Therapeutics Research, Director Phase I Program, City of Hope, discusses sequencing chemotherapy regimens in patients with metastatic pancreatic cancer.

Vincent Chung, MD, associate clinical professor, Department of Medical Oncology and Therapeutics Research, Director Phase I Program, City of Hope, discusses sequencing chemotherapy regimens in patients with metastatic pancreatic cancer.

When it comes to choosing a chemotherapy regimen for patients, much of the decision comes down to toxicity, says Chung. For that reason, Chung recommends starting these patients on gemcitabine and nab-paclitaxel (Abraxane). Although nab-paclitaxel causes a lot of neuropathy, it tends to resolve over time, he adds. If a patient progresses on that regimen, they can start on second-line nanoliposomal irinotecan and 5-fluorouracil, which offers good disease control.

As opposed to nab-paclitaxel, the neuropathy seen with the use of oxaliplatin is more permanent. Therefore, oxaliplatin is typically reserved for later lines of therapy, explains Chung. For a patient with a very good performance status who is given modified FOLFIRINOX, Chung advises dropping the oxaliplatin as neuropathy becomes more evident.

Related Videos
 Philip McCarthy, MD
Lova L. Sun, MD, MSCE
Robert M. Rifkin, MD, FACP
Ahmad Tarhini, MD, PhD
Allison Winter, MD
Rocio Garcia-Carbonero, MD
Andrew Ip, MD
Anthony B. El-Khoueiry, MD
Daniel King, MD, PhD
Camrelizumab plus rivoceranib vs sorafenib as first-line therapy for unresectable hepatocellular carcinoma (uHCC): Final overall survival analysis of the phase 3 CARES-310 study