Dr. Cohn on Frontline Therapies in Metastatic Pancreatic Cancer

Allen L. Cohn, MD, medical oncologist, Rocky Mountain Cancer Centers, discusses frontline therapies in metastatic pancreatic cancer.

For many years, the frontline standard of care in metastatic pancreatic cancer was gemcitabine monotherapy. Subsequently, FOLFIRINOX was introduced into the paradigm. Although the regimen can induce high response rates, it has a high incidence of toxicity. Then, the combination of gemcitabine and nab-paclitaxel (Abraxane) was found to show similar efficacy to that of FOLFIRINOX in the frontline setting. Although the combination has shown a lower response rate than what has been seen with FOLFIRINOX, it has a lower rate of toxicity, explains Cohn.

In terms of adjuvant chemotherapy, gemcitabine was the mainstay for many years. However, as in the frontline setting, FOLFIRINOX was found to be superior to gemcitabine monotherapy in terms of overall survival and progression-free survival, concludes Cohn.