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Pancreatic Cancer — SCE Medical Oncology MCQ

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HardGI CancersPancreatic CancerSCE Medical Oncology

A fit patient with metastatic pancreatic adenocarcinoma progresses after gemcitabine plus nab-paclitaxel. There is no dMMR/MSI-high status and no actionable alteration. Which regimen has phase III evidence specifically after gemcitabine-based therapy?

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Correct answer: C — Liposomal irinotecan with fluorouracil and folinic acid

NAPOLI-1 demonstrated benefit from liposomal irinotecan with fluorouracil/folinic acid after gemcitabine-based treatment. Full FOLFIRINOX is not the phase III post-gemcitabine regimen tested; gemcitabine rechallenge and pembrolizumab without dMMR lack this evidence, while fluorouracil/folinic acid alone was the comparator.

Reference: NAPOLI-1 trial. https://pubmed.ncbi.nlm.nih.gov/26615328/