In metastatic pancreatic cancer, surgery is used only for symptom control, such as for pain, jaundice, or gastric outlet obstruction. Radiation may be used for symptom relief, as well.
Chemotherapy can also help improve pancreatic cancer symptoms and improve chances of survival. Gemcitabine has been the most wildly used chemotherapy drug for treating metastatic pancreatic cancer. Other drug combinations include gemcitabine with erlotinib, gemcitabine with capecitabine, gemcitabine with cisplatin, and gemcitabine with nab-paclitaxel. If you’re in fairly good health, you may receive FOLFIRINOX (5-FU/leucovorin/oxaliplatin/irinotecan). Other combinations include gemcitabine alone or with another agent like (nab)-paclitaxel or capecitabine. Next line drug combinations to treat pancreatic cancer include oxaliplatin/fluoropyrimidine, or irinotecan liposome (Onivyde) in combination with fluorouracil plus leucovorin.