Table 4. Chemotherapy regimens for unresectable locally advanced or metastatic pancreatic cancer (For good performance status).
| Regimen | Detailed protocol |
| ECOG PS, Eastern Cooperative Oncology Group performance status; 5-FU, 5-fluorouracil; LV, leucovorin; MSI-H, microsatellite instability-high; dMMR, mismatch repair deficient. | |
| GN: Gemcitabine + Albumin-bound paclitaxel | Albumin-bound paclitaxel 125 mg/m2 ivgtt, d 1, 8
Gemcitabine 1,000 mg/m2 ivgtt, d 1, 8 Repeat every 3 weeks |
| GP: Gemcitabine + cisplatin (especially for hereditary cancer patients with potential BRCA1/2 or other DNA repair gene mutations) | Gemcitabine 1,000 mg/m2 ivgtt, d 1, 8
Cisplatin 75 mg/m2 ivgtt, d 1 Repeat every 3 weeks |
| FOLFIRINOX (only for patients with ECOG PS score 0−1) | Oxaliplatin 85 mg/m2 ivgtt, d 1
Irinotecan 180 mg/m2 ivgtt, d 1 LV 400 mg/m2 ivgtt, d 1 5-FU 400 mg/m2 ivgtt, d 1 Followed by 5-FU 2,400 mg/m2 continuous infusion over 46 h Repeat every 2 weeks |
| mFOLFIRINOX (only for patients with ECOG PS score 0−1) | Oxaliplatin 85 mg/m2 ivgtt, d 1
Irinotecan 150 mg/m2 ivgtt, d 1 LV 400 mg/m2 ivgtt, d 1 Followed by 5-FU 2,400 mg/m2 continuous infusion over 46 h Repeat every 2 weeks |
| Gemcitabine + erlotinib | Gemcitabine 1,000 mg/m2 ivgtt, d 1, 8
Erlotinib 150 mg/d po Repeat every 3 weeks |
| GX: Gemcitabine + capecitabine | Gemcitabine 1,000 mg/m2 ivgtt, d 1, 8
Capecitabine 1,660 mg/(m2·d), divided into two oral doses, d 1−14 Repeat every 3 weeks |
| GS: Gemcitabine + S-1 | Gemcitabine 1,000 mg/m2 ivgtt, d 1, 8
S1 80−120 mg/d divided into two oral doses d 1−14 Repeat every 3 weeks |
| Gemcitabine | Gemcitabine 1,000 mg/m2 ivgtt, d 1, 8
Repeat every 3 weeks |
| S-1 | S-1 80−120 mg/d divided into two oral doses d 1−14
Repeat every 3 weeks |
| Olaparib maintenance (for patients with germline BRCA1/2 mutations and good PS, who have not experienced disease progression for ≥16 weeks during the first-line platinum-containing regimen treatment.) | Olaparib 300 mg po bid |
| CapeOx: Oxaliplatin + capecitabine | Oxaliplatin 130 mg/m2 ivgtt, d 1
Capecitabine 2,000 mg/(m2·d), divided into two oral doses, d 1−14 Repeat every 3 weeks |
| 5-FU/LV | LV 400 mg/m2, ivgtt, d 1
5-FU 400 mg/m2, ivgtt, d 1 Followed by 5-FU 2,400 mg/m2 continuous infusion over 46 h Repeat every 2 weeks |
| Nanoliposomal irinotecan + 5-FU/LV | Nanoliposomal irinotecan 80 mg/m2, ivgtt, d 1
LV 400 mg/m2, ivgtt, d1 5-FU 2,400 mg/m2 continuous infusion over 46 h Repeat every 2 weeks |
| FOLFIRI | Irinotecan 180 mg/m2, ivgtt, d 1
LV 400 mg/m2, ivgtt, d 1 5-FU 400 mg/m2, ivgtt, d 1 Followed by 5-FU 2,400 mg/m2 continuous infusion over 46 h Repeat every 2 weeks |
| Pembrolizumab (only for patients with MSI-H or dMMR) | Pembrolizumab 200 mg ivgtt, d 1
Repeat every 3 weeks |