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Videos

1 expert is featured in this series.

A panelist discusses how proactive adverse event management is crucial for patients with metastatic pancreatic cancer, including using every-2-week scheduling and primary granulocyte colony-stimulating factor (G-CSF) support to reduce myelosuppression, providing extensive patient counseling about diet, hydration, and early antidiarrheal use for liposomal irinotecan-related diarrhea, and closely monitoring for cumulative neuropathy with consideration of oxaliplatin discontinuation by 3 to 4 months if responding to prevent limitations on future therapy options.

1 expert is featured in this series.

A panelist discusses how treating metastatic pancreatic cancer requires a multidisciplinary approach with early palliative care and dietitian involvement, emphasizing that for patients with good performance status, 3-drug regimens like NALIRIFOX or modified FOLFIRINOX can provide clinical responses and quality-of-life improvements even in high disease burden cases, whereas frail patients benefit from gemcitabine plus nab-paclitaxel administered every 2 weeks, and notes that age alone should not exclude patients from 3-drug regimens as the NAPOLI-3 trial included patients aged up to 85 years.

1 expert in this video

Panelist discusses how NALIRIFOX (liposomal irinotecan, 5-fluorouracil [5-FU], leucovorin, oxaliplatin) management requires careful attention to cytopenia prevention through growth factor use and aggressive diarrhea management with patient education and antidiarrheal medications.

1 expert in this video

Panelist discusses how the development of nanoliposomal irinotecan led to the NAPOLI-1 trial showing a survival benefit in second-line treatment and subsequently the NAPOLI-3 trial demonstrating the superiority of NALIRIFOX (liposomal irinotecan, 5-fluorouracil [5-FU], leucovorin, oxaliplatin) over gemcitabine/nab-paclitaxel in first-line metastatic disease.

1 expert is featured in this series.

Overview of Clinical Trial Data A panelist discusses how first-line treatment recommendations are based on 3 pivotal phase 3 randomized trials: PRODIGE 4 (which established FOLFIRINOX superiority over gemcitabine with 11.1 vs 6.8 months overall survival despite higher toxicity), MPACT (showing gemcitabine plus nab-paclitaxel benefit over single-agent gemcitabine with 8.5 vs 6.7 months survival), and the recent NAPOLI-3 (demonstrating NALIRIFOX superiority over gemcitabine plus nab-paclitaxel with 11.1 vs 9.2 months overall survival in over 750 patients across 180 sites).

1 expert is featured in this series.

A panelist discusses how treatment selection for metastatic pancreatic adenocarcinoma involves evaluating multiple factors including genetic and somatic mutations (particularly homologous recombination deficiency [HRD] alterations like BRCA1/2 and PALB2, which favor platinum-based regimens), patient age and performance status, liver function status, and drug metabolism genotype testing such as dihydropyrimidine dehydrogenase (DPD) deficiency screening to avoid severe 5-FU toxicity in rare cases of homozygous variants.

1 expert in this video

Panelist discusses how the landmark ACCORD 11 trial established FOLFIRINOX (leucovorin calcium, fluorouracil, irinotecan hydrochloride, and oxaliplatin) as superior to gemcitabine for fit, young patients, whereas the MPACT trial demonstrated that gemcitabine plus nab-paclitaxel provided a more tolerable option for older patients with less preserved performance status.

1 expert in this video

Panelist discusses how CA 19-9 serves as a useful tumor marker for disease monitoring and recurrence detection in patients with pancreatic cancer, though it requires normalization of bilirubin levels for accurate baseline assessment.

1 expert is featured in this series.

A panelist discusses how first-line treatment for metastatic pancreatic cancer depends on performance status. ECOG 0-1 patients receive preferred options like FOLFIRINOX, modified FOLFIRINOX, or the newly FDA-approved NALIRIFOX regimen (which includes liposomal irinotecan for enhanced drug delivery), whereas ECOG 2 patients typically receive gemcitabine plus nab-paclitaxel, and ECOG 3 patients receive palliative care.

1 expert is featured in this series.

A panelist discusses how a man aged 82 years with good performance status presented with unexplained weight loss and abdominal pain, leading to a diagnosis of metastatic pancreatic adenocarcinoma with KRAS G12D and TP53 mutations confirmed through imaging, biopsy, and next-generation sequencing (NGS) testing.