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Opinion|Videos|January 21, 2026

Interpreting NAPOLI 3 Data and the Clinical Meaning of Dose Modifications in Metastatic Pancreatic Cancer

Author(s)Dan Zhao, MD, PhD , Axel Grothey, MD, Jonathan Lee, MD, MSc

Experts discuss evolving treatment strategies for metastatic pancreatic cancer, comparing NALIRIFOX and FOLFIRINOX in first-line therapy decisions.

Episodes in this series

Experts featured in this series.

EP. 1 Evolving First Line Treatment Selection in Metastatic Pancreatic Ductal Adenocarcinoma

Experts featured in this series.

EP. 2 Interpreting NAPOLI 3 Data and the Clinical Meaning of Dose Modifications in Metastatic Pancreatic Cancer

This segment focuses on findings from the NAPOLI 3 trial that most clearly differentiate Nalirifox from FOLFIRINOX in metastatic pancreatic ductal adenocarcinoma. Faculty review overall survival outcomes and discuss why these results have influenced treatment paradigms in first line metastatic disease.

A major focus is the post hoc analysis demonstrating improved survival among patients who required dose reductions. Panelists explore how these findings should be interpreted, including concerns related to selection bias, while emphasizing their relevance to real world practice. Rather than viewing dose reductions as a compromise, faculty describe them as part of proactive toxicity management that allows patients to remain on therapy longer.

The discussion highlights how adverse event monitoring, early intervention, and individualized dosing strategies support sustained treatment exposure without sacrificing efficacy. Faculty share real world experience applying these principles and explain how thoughtful dose adjustments can enhance both safety and long term outcomes.

This segment reinforces the importance of translating clinical trial data into practical approaches that reflect the realities of treating patients with metastatic pancreatic ductal adenocarcinoma.

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9th Annual School of Nursing Oncology™

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Beth Faiman, PhD, MSN, APN-BC, BMTCN, AOCN, FAAN, FAPO; Beth Sandy, MSN, CRNP, FAPO; Lindsay Adkins, MSN, FNP-BC, BMTCN; Jeneth Aquino, DNP, FNP-BC; Casey Gormley, MSN, FNP-C, AOCNP; Heather J. Jackson, PhD, FNP-BC; Kelsey Martin, AG-ACNP-BC, AOCNP; Nerina T. McDonald, PA-C; Lauren Verity Moore, DNP, MSN, AGACNP-BC; Faith A. Mutale, DNP, CRNP; Tiffany Richards, PhD, ANP-BC, AOCNP; Emily Skotte, DNP, MSN, ACNP-BC; Leslie Smith, DNP, RN, APRN-CNS, AOCNS, BMTCN; Saneese Stephen, PA-C, MPAS; Sara M. Tinsley-Vance, PhD, APRN, AOCN

Community Practice Connections™: DLL3-Targeting Bispecific Antibodies for Small Cell Lung Cancer—From Innovation to Practice

Community Practice Connections™: DLL3-Targeting Bispecific Antibodies for Small Cell Lung Cancer—From Innovation to Practice

Jacob Sands, MD; Anne Chiang, MD, PhD

The Rise of Novel HER2-Targeting Therapies in GEA: Mechanisms and Clinical Data

The Rise of Novel HER2-Targeting Therapies in GEA: Mechanisms and Clinical Data

Rahul Gosain, MD, MBA; Rohit Gosain, MD

(Pharmacist Track) Tackling Oncologic Emergencies in Patients Treated With High-Dose Methotrexate

(Pharmacist Track) Tackling Oncologic Emergencies in Patients Treated With High-Dose Methotrexate

Shazia Nakhoda, MD; Shruti Gupta, MD, MPH; Anitha Varghese, MSN, APRN, AGPCNP-C

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