Dr. Jones on Selecting Between Frontline Regimens in Pancreatic Cancer

Amy Jones, MD, associate program director, Hematology Oncology Fellowship Program, assistant professor, UT Southwestern Medical Center, discusses factors that can inform frontline treatment selection in pancreatic cancer.

For the majority of patients with pancreatic cancer who have an ECOG performance status of 1 or 2, FOLFIRINOX remains the standard of care, says Jones. This is based on data from the PRODIGE 4/ACCORD 11 trial in which FOLFIRINOX improved overall survival vs gemcitabine in patients with pancreatic cancer. Patients may also derive improved disease control with FOLFIRINOX compared with gemcitabine plus nab-paclitaxel (Abraxane), Jones says.

However, other factors beyond performance status could inform which frontline therapy is optimal for patients, Jones explains. For example, patients who do not want a port are likely better suited for gemcitabine/nab-paclitaxel because a port is needed for FOLFIRINOX administration, says Jones. Other factors such as treatment schedule, age, and presence of peripheral neuropathy or other comorbidities may also inform treatment selection, concludes Jones.