What third line treatment do you consider for a patient with metastatic pancreatic cancer with good functional status and no targetable mutations after progression on FOLFIRINOX and gemcitabine/nab-paclitaxel?

Topics: Gastrointestinal Cancers • Medical Oncology • Liver and Pancreas Tumors • Pancreatic Cancer

Answer from: Medical Oncologist at Academic Institution

Sadly, there is absolutely no "standard" option in this space, as no trials have demonstrated any meaningful benefit. I personally would not just "try" a therapy - and I would especially not just "try" an immune checkpoint inhibitor, as these, as single agents have shown no benefit at all (if the t...

Comments

Medical Oncologist at Beaumont Health System
I was considering gemcitabine and erlotinib for th...

Medical Oncologist at Clinical Instructor
We've discussed gemcitabine/erlotinib use in this ...

Answer from: Medical Oncologist at Academic Institution

Agree with a thorough look for an actionable alteration and/or a phase I trial if possible. There may be a very modest benefit of nal-Iri in PC after FOLFIRINOX according to a recent retrospective study, so previous irinotecan may not always mean there is no benefit from Nal-Iri based therapy. ...

Answer from: Medical Oncologist at Community Practice

Napoli-1 trial.Consider Liposomal Irinotecan with 5FU, Leucovorin.

Comments

Medical Oncologist at Harvard Medical School
Napoli 1 was post gem based only.

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