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Potential treatment sequencing approach for MPC in 2019?

Nab-paclitaxel +

gemcitabine

(if no neuropathy

)

Gemcitabine

FOLFIRINOX

Nab-paclitaxel +

gemcitabine

MM-398 +

5-FU/LV

OFF

Capecitabine

MM-398 + 5-FU/LV

(depending on

prior exposure)

1

st

line

2

nd

line

3

rd

line

NOTE: Nab-paclitaxel is licensed for use in combination with gemcitabine as

1

st

-line therapy for patients with MPC

Nab-paclitaxel?

(depending on

prior exposure)

mFOLFOX6 or CAPOX

Platinum-based tx

(depending on

prior exposure)

Supported by RCT data

Supported by retrospective data or small,

single arm trials

5-FU