Metastatic Pancreatic Adenocarcinoma (PDAC)

Metastatic Pancreatic Adenocarcinoma (PDAC) refers to pancreatic cancer that has spread to other sites in the body.

Chemotherapy is recommended for patients who are physically fit. For patients who are not physically fit, best supportive care, which is medical care that focuses on relieving the symptoms caused by serious illnesses, should be considered as the main treatment option.

The types of chemotherapy first recommended may include drug combinations including FOLFIRINOX or a combination of gemcitabine and abraxane.

FOLFIRINOX is a mixture of anti-cancer drugs for colon cancer comprising the drugs 5-Fluorouracil (5-FU), leucovorin, oxaliplatin and irinotecan. 5-FU works by interfering with genetic replication of rapidly-dividing cancer cells. Leucovorin is given in combination with 5-FU to enhance its effectiveness. Oxaliplatin, irinotecan, gemcitabine and abraxane are anti-cancer chemotherapy drugs that reduce cancer growth.

Should the first drug/drugs used not work well in shrinking the tumour, or are poorly tolerated, it is recommended to adopt chemotherapy including fluoropyrimidine if previously treated with chemotherapy including gemcitabine, or chemotherapy including gemcitabine if previously treated with fluoropyrimidine-based therapy. These drugs interfere with the DNA replication of rapidly-dividing cancer cells.