Dr. Ma on First-Line Treatment Considerations in Metastatic Pancreatic Cancer

Wen Wee Ma, MBBS, professor of oncology, consultant, Division of Medical Oncology, Department of Oncology, Mayo Clinic, discusses first-line treatment considerations in metastatic pancreatic cancer.

Currently, frontline treatment options for patients with metastatic pancreatic cancer consist of FOLFIRINOX or gemcitabine plus nab-paclitaxel (Abraxane), says Ma. Although both regimens were FDA approved based on pivotal clinical trials, they have not yet been compared directly, Ma says.

As such, treatment considerations are needed to determine which patients should receive which regimen, Ma adds. A patient’s fitness level and age should be considered during treatment selection, Ma says. The population in the clinical trial that led to the FDA approval of FOLFIRINOX included patients under the age of 75; however, clinical experience has been gleaned with using FOLFIRINOX in patients older than 75 who have robust health, Ma explains.

Ultimately, treatment selection should be a shared decision between the provider and patient, Ma says. For example, some patients may elect to receive gemcitabine/nab-paclitaxel over FOLFIRINOX based on the potential effects FOLFIRINOX could have on their quality of life, concludes Ma.