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Pancreatic Cancer — SCE Medical Oncology MCQ

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ModerateGI CancersPancreatic CancerSCE Medical Oncology

A 65-year-old man is diagnosed with periampullary adenocarcinoma and undergoes Whipple procedure (pancreaticoduodenectomy). Final pathology confirms pT3 N1 (3/18 nodes positive) adenocarcinoma of the pancreatic head with clear margins. What adjuvant chemotherapy is recommended?

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Correct answer: A — Gemcitabine + capecitabine for 6 months

The ESPAC-4 trial demonstrated that adjuvant gemcitabine + capecitabine for 6 months significantly improved OS compared with gemcitabine monotherapy for resected pancreatic cancer (median OS 28.0 vs 25.5 months). Modified FOLFIRINOX (PRODIGE 24/CCTG PA.6 trial) is an alternative for fit patients, showing superior OS but greater toxicity. Choice depends on patient fitness. Gemcitabine monotherapy remains an option for those unable to tolerate doublet therapy.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer