NCCN Guidelines for Pancreatic Adenocarcinoma V.1.
2022 – Annual on 01/24/2022
Guideline Page
and Request
PANC-F (3/4/6 of 9)
Internal request:
Comment to consider the inclusion of gemcitabine +
albumin-bound paclitaxel + cisplatin as an option in the
following settings:
• locally advanced disease (first-line therapy)
• metastatic disease (first-line therapy)
• Subsequent therapy for locally
advanced/metastatic disease and therapy for
recurrent disease (if prior fluoropyrimidine-
based therapy)
PANC-F (6 of 9)
Internal request:
Comment to consider entrectinib as a preferred
subsequent therapy option for those with locally
advanced/metastatic/recurrent disease and Poor PS.
Institution Vote
Panel Discussion/References
YES NO ABSTAIN ABSENT
Based on the review of the data in the noted
reference, the panel consensus was to include
gemcitabine + albumin-bound paclitaxel + cisplatin as
an option for the following:
• Locally advanced disease (first-line therapy). 15 3 7 7
This is a category 2B, other recommended
regimen.
• Metastatic disease (first-line therapy). This is 18 2 5 7
a category 2A, other recommended regimen.
• Subsequent therapy for locally 15 4 6 7
advanced/metastatic disease and therapy for
recurrent disease (if prior fluoropyrimidine-
based therapy). This is a category 2B, other
recommended regimen.
Reference
• Jameson GS, Borazanci E, Babiker HM, et
al. Response Rate Following Albumin-Bound
Paclitaxel Plus Gemcitabine Plus Cisplatin
Treatment Among Patients With Advanced
Pancreatic Cancer: A Phase 1b/2 Pilot
Clinical Trial [published online ahead of print,
2019 Oct 3] [published correction appears in
JAMA Oncol. 2019 Nov 1;5(11):1643]. JAMA
Oncol. 2019;6(1):125-132.
• Shroff RT, Javle MM, Xiao L, et al.
Gemcitabine, Cisplatin, and nab-Paclitaxel
for the Treatment of Advanced Biliary Tract
Cancers: A Phase 2 Clinical Trial. JAMA
Oncol. 2019;5(6):824-830.
Based on the review of the data and discussion, the 18 1 6 7
panel consensus supported the continued listing of
entrectinib an acceptable subsequent therapy option
for those with locally advanced/metastatic/recurrent
NCCN Guidelines for Pancreatic Adenocarcinoma V.1.2022 – Annual on 01/24/2022

disease and Poor PS with a change in category from

a category 2B, useful in certain circumstances to a
category 2A, preferred recommendation.