Andrew H. Ko, MD, Andrew E. Hendifar, MD, MPH, and George P. Kim, MD, prepared useful practice aids pertaining to pancreatic cancer for this CME activity titled "The Quest to Win Through Science in Pancreatic Cancer: From Sequencing Current Options to Testing Novel Approaches." For the full presentation, monograph, complete CME information, and to apply for credit, please visit us at http://bit.ly/2F5JPi2. CME credit will be available until March 15, 2019.

1. This Practice Aid has been provided as a quick reference to help learners apply the information to their daily practice and care of patients.
Classifying Pancreatic Cancer and
Available Options for Advanced Disease
FOLFIRINOX: 5-FU, leucovorin, irinotecan, and oxaliplatin; RR: response rate.
1. https://www.lustgarten.org/get-informed/stages-of-pancreatic-cancer. Accessed December 21, 2017. 2. NCCN Clinical Practice Guidelines in Oncology. Pancreatic Adenocarcinoma. Version 3.2017. September 11, 2017. https://www.nccn.org/professionals/
physician_gls/pdf/pancreatic.pdf. Accessed December 21, 2017. 3. Conroy T et al. N Engl J Med. 2011;364:1817-1825. 4. Von Hoff DD et al. N Engl J Med. 2013;369:1691-1703. 5. Goldstein D et al. J Natl Cancer Inst. 2015;107(2). 6. Wang-Gillam A et al. Lancet.
2016;387:545-557.
PRACTICE AID
Access the activity,“The Quest to Win Through Science in Pancreatic Cancer: From Sequencing Current Options
to Testing Novel Approaches,”at www.peerview.com/NMJ40.
A Resource for Professional-Patient Conversations: Simplified Clinical Classification of Pancreatic Cancer
More information available for patients at lustgarten.org and letswinpc.org
Resectable pancreatic cancer can be surgically removed1,2
Confined to area
around pancreas;
intertwined with blood
vessels; invasion of
surrounding organs
Tumors may lie within
the pancreas or extend
beyond, but NO
involvement of critical
arteries or veins
Liver
Stomach
Gallbladder
Lymph nodes
Pancreas Cancer cells
Locally advanced, unresectable: treatment includes chemotherapy, clinical trials, radiotherapy1,2
Liver
Stomach
Gallbladder
Lymph nodes
Pancreas Cancer cells
No evidence
of spread to areas
outside of the
tissue removed
during surgery
No evidence
of spread to
other areas
of the body

2. This Practice Aid has been provided as a quick reference to help learners apply the information to their daily practice and care of patients.
Classifying Pancreatic Cancer and
Available Options for Advanced Disease
FOLFIRINOX: 5-FU, leucovorin, irinotecan, and oxaliplatin; RR: response rate.
1. https://www.lustgarten.org/get-informed/stages-of-pancreatic-cancer. Accessed December 21, 2017. 2. NCCN Clinical Practice Guidelines in Oncology. Pancreatic Adenocarcinoma. Version 3.2017. September 11, 2017. https://www.nccn.org/professionals/
physician_gls/pdf/pancreatic.pdf. Accessed December 21, 2017. 3. Conroy T et al. N Engl J Med. 2011;364:1817-1825. 4. Von Hoff DD et al. N Engl J Med. 2013;369:1691-1703. 5. Goldstein D et al. J Natl Cancer Inst. 2015;107(2). 6. Wang-Gillam A et al. Lancet.
2016;387:545-557.
PRACTICE AID
Access the activity,“The Quest to Win Through Science in Pancreatic Cancer: From Sequencing Current Options
to Testing Novel Approaches,”at www.peerview.com/NMJ40.
Metastatic pancreatic cancer: chemotherapy can be used across multiple lines of therapy;
clinical trials are an important treatment option1,2
Modern chemotherapy options in advanced pancreatic cancer
Has spread beyond
the area of the
pancreas and involves
other organs
• Improves RR, PFS, OS
• Cytopenias, fatigue, peripheral sensory
neuropathy; consider primary growth
factor prophylaxis
• Biweekly dosing; requires infusion pump,
central IV access
• Improves RR, PFS, OS
• Cytopenias, fatigue, alopecia, peripheral
sensory neuropathy (usually reversible)
• 3 of 4 weeks dosing schedule
• Improves objective response, PFS, OS
• Neutropenia, fatigue, diarrhea, vomiting
• IV infusion every 2 weeks
FOLFIRINOX3
Gemcitabine + nab-paclitaxel4,5
Nanoliposomal irinotecan (nal-IRI)6
Liver
Stomach
Gallbladder
Lymph nodes
Pancreas Cancer cells
Involved organs
may include the
liver and lungs;
other areas of
the abdomen may
be affected

3. Access the activity,“The Quest to Win Through Science in Pancreatic Cancer:
From Sequencing Current Options to Testing Novel Approaches,”at
www.peerview.com/NMJ40.
AGuidetoClinicalTrialsinPancreatic
Cancer:FocusonModernTreatment
PlatformsandNovelTherapeutics
PRACTICE AID
This Practice Aid has been provided as a quick reference to help learners apply the information to their daily practice and care of patients.
5-FU: 5 fluorouracil; CT: chemotherapy; FOLFIRINOX: 5-FU, leucovorin, irinotecan, and oxaliplatin; FOLFOX: folinic acid, fluorouracil, and oxaliplatin; IDO: indoleamine 2,3 dioxygenase;
LV: leucovorin; nab-paclitaxel: nanoparticle albumin–bound paclitaxel; nal-IRI: nanoliposomal irinotecan; SBRT: stereotactic body radiation therapy; TTFields: tumor-treating fields.
HALO-109-301: PEGPH20 ± gemcitabine/
nab-paclitaxel in hyaluronan-high disease
(NCT02715804)
CARRIE: MM-141 (IGF-1R and ErbB3
antibody [NCT02399137])
NLG2104: Indoximod (IDO inhibitor
[NCT02077881])
Nivolumab + cisplatin + paricalcitol
(NCT02754726)
± olaratumab (NCT03086369)
144525: ibrutinib (NCT02562898)
Nal-IRI + 5-FU/LV + oxaliplatin vs nal-IRI +
5-FU/LV vs nab-paclitaxel + gemcitabine
(NCT02551991)
POLO: olaparib in gBRCA-mutated disease
that has not progressed on first-line CT
(NCT02184195)
CanStem111P: napabucasin (cancer stemness
inhibitor ± gemcitabine/nab-paclitaxel)
(NCT02993731)
Clinical trials can be an important
therapeutic tool for the treatment
of pancreatic cancer
These selected trials and other
resources provided can be
shared with your patients
Frontline
Metastatic
Phase3
Combinations With
Gemcitabine +
Nab-Paclitaxel
Other Frontline/
Maintenance Trials
Phase 2
Previously
Treated
Metastatic
Olaparib BRCAness phenotype in pancreatic
cancer (NCT02677038)
PembroPlus: pembrolizumab + nab-paclitaxel/
gemcitabine (phase 1/2; NCT02331251)
NivoPlus: + CT (phase 1/2; NCT02423954)
Sequoia: AM0010+FOLFOXvsFOLFOX
(NCT02923921)
Olaparib + cediranib (NCT02498613)
Phase2

4. Access the activity,“The Quest to Win Through Science in Pancreatic Cancer:
From Sequencing Current Options to Testing Novel Approaches,”at
www.peerview.com/NMJ40.
AGuidetoClinicalTrialsinPancreatic
Cancer:FocusonModernTreatment
PlatformsandNovelTherapeutics
PRACTICE AID
This Practice Aid has been provided as a quick reference to help learners apply the information to their daily practice and care of patients.
5-FU: 5 fluorouracil; CT: chemotherapy; FOLFIRINOX: 5-FU, leucovorin, irinotecan, and oxaliplatin; FOLFOX: folinic acid, fluorouracil, and oxaliplatin; IDO: indoleamine 2,3 dioxygenase;
LV: leucovorin; nab-paclitaxel: nanoparticle albumin–bound paclitaxel; nal-IRI: nanoliposomal irinotecan; SBRT: stereotactic body radiation therapy; TTFields: tumor-treating fields.
Let’sWin offers information for
patients on therapies being tested
in clinical trials
Pancreatic Cancer Action
Network offers several
clinical trial resources
Other
Settings
 Clinical trial search for patients
and professionals
 Clinical trial FAQ
 Free education packet
 Informational video
clinicaltrials.pancan.org
 Neoadjuvant therapy
 Experimental drug combinations
 Immunotherapy
 Maintenance therapy
 Radiation
… and much more
letswinpc.org/clinical-trials
Second-line nab-paclitaxel + gemcitabine
vs FOLFOX for post-resection
gemcitabine-refractory disease (NCT02506842)
RTOG 0848: gemcitabine ± erlotinib →
CT ± radiation (NCT01013649)
Phase3PostResection
PANOVA-3: TTFields with concomitant
gemcitabine and nab-paclitaxel (NCT03377491)
PANC0015/27492: FOLFIRINOX +/- SBRT
(NCT01926197)
Phase3
LocallyAdvanced
S1505: nab-paclitaxel/gemcitabine or
FOLFIRINOX (NCT02562716)
PEGPH20, gemcitabine, and nab-paclitaxel;
run-in followed by neoadjuvant treatment
(NCT02487277)
Gemcitabine/nab-paclitaxel + radiation
followed by surgery (NCT02481635)
UVA-PC-PD101: chemoradiotherapy ±
pembrolizumab (NCT02305186)
Phase2
Neoadjuvant