First-Line Treatment Options for Metastatic Pancreatic Adenocarcinoma
Panelists discuss how the current first-line treatment landscape for metastatic pancreatic adenocarcinoma includes NCCN-recommended regimens like FOLFIRINOX, gemcitabine plus nab-paclitaxel, and newest addition NALIRIFOX, with treatment selection guided by toxicity profiles, patient-specific factors, and the importance of germline testing.
EP: 1.First-Line Treatment Options for Metastatic Pancreatic Adenocarcinoma
EP: 2.Insights From The NAPOLI-3 and PRODIGE4 Trials In Metastatic Pancreatic Adenocarcinoma
EP: 3.Managing AEs Associated With the FOLFIRINOX and NALIRIFOX Regimens in Pancreatic Cancer
EP: 4.NAPOLI-3 in Real World Practice: Expert Insights on Data From ASCO GI 2025
EP: 5.Evaluating the Impact of UGT1A128 Status on Tolerability Of NALIRIFOX in mPDAC
EP: 6.NALIRIFOX In Practice: Treatment Strategies for Patients With mPDAC
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In this Cancer Network Frontline Forum program, Sreenivasa Chandana, MD, PhD and Darshil Shah, MD, MPH discuss navigating first-line therapy options for metastatic pancreatic adenocarcinoma. Dr. Chandana, a gastrointestinal (GI) medical oncologist from the Cancer and Hematology Centers in Grand Rapids, Michigan, specializes in pancreatic cancer research and drug development. Dr. Shah is a GI medical oncologist and director of the gastrointestinal oncology division at Ironwood Cancer and Research Centers in Phoenix, Arizona.
The program serves as an extension of a previous meeting in which expert faculty discussed key clinical data updates for frontline therapy in metastatic pancreatic adenocarcinoma. The 2 physicians plan to review the latest data and share insights on applying this information to clinical practice. They begin by discussing the current treatment landscape for first-line metastatic pancreatic adenocarcinoma therapy.
Dr. Shah explains that the first-line treatment landscape includes multiple NCCN-recommended regimens for patients with ECOG performance status of 0 or 1, including FOLFIRINOX, gemcitabine plus nab-paclitaxel, and the newest addition, NALIRIFOX (based on the NAPOLI-3 study). While each regimen demonstrates efficacy, toxicity profiles and patient-specific factors guide treatment selection. Dr Shah also emphasizes the importance of germline testing, as approximately 10% of pancreatic ductal adenocarcinomas are driven by germline mutations that benefit from platinum-based regimens.
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