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Pancreatic cancer: options by country

Sourced options by country plus visit-prep questions for Pancreatic cancer. Each line links to its regulator, HTA, or guideline source. This page maps options; it does not recommend or rank them.

Options mappedSolid tumorLast checked June 2026

What this page does

Maps options by country

It maps sourced options by country alongside diagnosis wording, stage, test results, specialists, and trial-search terms.

What it does not do

Does not choose treatment

It does not rank treatments, recommend a choice, or decide clinical fit.

Where it comes from

Built on trusted sources

Every option links to a trusted regulator, HTA, or guideline source, and the list grows as new sources pass verification.

Information to gather before the next visit

  • Is the cancer considered resectable, borderline resectable, locally advanced, or metastatic?
  • Has a pancreatic-surgery multidisciplinary team reviewed the imaging?
  • Would chemotherapy or chemoradiation be considered before or after surgery?
  • Is the goal local control, symptom relief, or part of a planned multimodality approach?

Trial-search terms to discuss

Pancreatic cancer clinical trial

Options by country

Treatments by country

Regulatory and access status by country, from official sources. It shows what exists and where — not a recommendation.

United States

  • chemotherapy with possible chemoradiation or radiation therapy approaches as described by NCI PDQ[1]Standard option (per NCI PDQ)not biomarker-specific; locally advanced pancreatic cancer; selected non-metastatic disease after chemotherapy. · NCI PDQ describes radiation/chemoradiation options by disease setting, not a universal sequence. Local anatomy, systemic disease status, symptoms, and center expertise matter. Confidence/conflicts: high for NCI PDQ treatment-category support; no conflict identified.
  • irinotecan liposome (Onivyde) with fluorouracil and leucovorin[2]FDA-approvednot biomarker-specific; after disease progression following gemcitabine-based therapy. · This is an FDA-label indication after gemcitabine-based therapy. It does not imply eligibility, benefit, or tolerability for an individual patient. Confidence/conflicts: high for FDA-label indication; no conflict identified.
  • irinotecan liposome (Onivyde) with oxaliplatin, fluorouracil, and leucovorin[2]FDA-approvednot biomarker-specific; first-line metastatic pancreatic adenocarcinoma in adults. · This is an FDA-label indication; individual suitability, contraindications, organ function, and supportive-care needs require clinician review. No dosing is provided here. Confidence/conflicts: high for FDA-label indication; no conflict identified.
  • olaparib (Lynparza)[3]FDA-approveddeleterious or suspected deleterious germline BRCA-mutated; maintenance after at least 16 weeks of first-line platinum-based chemotherapy without progression. · The label requires germline BRCA mutation status and non-progression after first-line platinum-based chemotherapy. It does not establish suitability for people without that biomarker/setting. Confidence/conflicts: high for FDA-label indication; no conflict identified.
  • surgery for resectable or borderline resectable pancreatic cancer, including pancreaticoduodenectomy or distal/subtotal pancreatectomy approaches as appropriate to tumor location[1]Standard option (per NCI PDQ)not biomarker-specific; resectable or borderline resectable pancreatic cancer. · Surgical candidacy depends on staging, anatomy, performance status, and multidisciplinary assessment. This entry is an option to discuss with the treating team, not a statement that surgery is available or appropriate for an individual patient. Confidence/conflicts: high for NCI PDQ treatment-category support; no conflict identified.
  • zenocutuzumab-zbco (Bizengri)[4]FDA accelerated approvalNRG1 gene fusion; after disease progression on or after prior systemic therapy. · Approval is accelerated and limited to NRG1 fusion-positive disease in the specified setting. Continued approval may depend on confirmatory evidence, and biomarker testing is essential. Confidence/conflicts: high for FDA approval notice; no conflict identified.

European Union

  • irinotecan hydrochloride trihydrate pegylated liposomal (Onivyde pegylated liposomal) with 5-fluorouracil and leucovorin[5]EMA authorisednot biomarker-specific; after progression following gemcitabine-based therapy. · EMA central authorisation does not establish reimbursement, access, or patient-specific suitability in each member state. Confidence/conflicts: high for EMA authorised indication; no conflict identified.
  • irinotecan hydrochloride trihydrate pegylated liposomal (Onivyde pegylated liposomal) with oxaliplatin, 5-fluorouracil, and leucovorin[5]EMA authorisednot biomarker-specific; first-line adult metastatic adenocarcinoma of the pancreas. · EMA central authorisation does not determine member-state reimbursement, center access, or individual suitability. Germany and France reimbursement/benefit assessment should be checked separately. Confidence/conflicts: high for EMA authorised indication; no conflict identified.
  • irinotecan liposomal pegylated / pegylated liposomal irinotecan (Onivyde) with 5-fluorouracil and leucovorin[6]Approvednot biomarker-specific; metastatic pancreatic adenocarcinoma after progression following treatment including gemcitabine. · HAS notes limitations in comparator choice and tolerability. This is a French HTA/reimbursement-context source, not a statement of individual suitability. Confidence/conflicts: high for HAS opinion; no conflict identified.
  • olaparib (Lynparza)[7]EMA authorisedgermline BRCA1/2 mutation; maintenance after a minimum of 16 weeks of first-line platinum treatment without progression. · EMA product information requires germline BRCA1/2 confirmation with a validated test; national reimbursement and access differ by member state. Confidence/conflicts: high for EMA authorised indication; no conflict identified.
  • olaparib (Lynparza)[8]Approvedgermline BRCA1/2 mutation; maintenance after at least 16 weeks of first-line platinum treatment without progression, when continuation of platinum-based chemotherapy is not suitable. · HAS rates clinical benefit moderate in the restricted subgroup and no clinical added value; outside the precise subgroup, HAS says the clinical benefit is insufficient for public funding. Confidence/conflicts: high for HAS reimbursement/care-pathway position; no conflict identified.
  • olaparib (Lynparza)[9]G-BA benefit assessmentgermline BRCA1/2 mutation; maintenance after a minimum of 16 weeks of platinum treatment within first-line chemotherapy without progression. · This is a G-BA courtesy translation; the German original is legally binding. "Additional benefit not proven" is a benefit-assessment conclusion, not a statement that the medicine lacks marketing authorisation. Confidence/conflicts: high for G-BA courtesy translation; German original legally binding. No conflict identified.
  • pegylated liposomal irinotecan (Onivyde pegylated liposomal) with oxaliplatin, 5-fluorouracil, and leucovorin[10]HAS reimbursement opinionnot biomarker-specific; metastatic adenocarcinoma of the pancreas; first-line context is implied by the EMA indication and HAS linked 2025 opinion summary but should be confirmed in the detailed French opinion before patient-facing reuse. · The fetched HAS index page gives the favourable-opinion summary but not the full detailed indication text in English. Confirm the detailed 2025 opinion and French reimbursement criteria before surfacing beyond link-only summary. Confidence/conflicts: medium-high; favourable reimbursement signal is clear, but detailed indication text should be fetched from the linked opinion for final patient-facing copy. No conflict identified.

United Kingdom

  • FOLFIRINOX chemotherapy regimen[11]NICE recommendednot biomarker-specific; first-line metastatic pancreatic cancer; ECOG performance status 0 to 1. · NICE notes off-label use in February 2018. This is a guideline recommendation and does not establish individual suitability, toxicity tolerance, or local prescribing details. Confidence/conflicts: high for NICE guideline support; no conflict identified.
  • larotrectinib (Vitrakvi)[12]ApprovedNTRK gene fusion; locally advanced or metastatic NTRK fusion-positive solid tumors, or surgery-morbid context, with no satisfactory treatment options. · This is histology-independent and Cancer Drugs Fund-managed access, not pancreatic-specific routine commissioning for all PDAC. Confirmation of NTRK fusion and CDF criteria is necessary. Confidence/conflicts: medium-high; solid-tumor recommendation is clear, but pancreatic applicability depends on rare NTRK fusion and managed-access criteria. No conflict identified.
  • nab-paclitaxel / paclitaxel as albumin-bound nanoparticles with gemcitabine[13]NICE recommendednot biomarker-specific; untreated metastatic adenocarcinoma of the pancreas. · Recommendation is restricted by suitability of other combination chemotherapy and a patient access scheme; it is not a broad first-line recommendation for all metastatic PDAC. Confidence/conflicts: high for NICE recommendation; no conflict identified.
  • resectional surgery, including pylorus-preserving resection when tumor can be adequately resected[11]NICE recommendednot biomarker-specific; surgery for head of pancreas cancer when resection is being undertaken and adequate resection is possible. · NICE guidance is not a statement that a person is operable. Resectability, fitness, staging, and local MDT review remain central. Confidence/conflicts: high for NICE guideline support; no conflict identified.

Japan

  • FOLFIRINOX chemotherapy[14]Standard option (per International Journal of Clinical Oncology / Japan Pancreas Society)not biomarker-specific; first-line chemotherapy for pancreatic cancer with distant metastases. · This is guideline evidence from an English synopsis, not a drug label or reimbursement rule. Fitness, organ function, and local regimen availability require Japanese treating-team confirmation. Confidence/conflicts: high for guideline recommendation; no conflict identified.
  • endoscopic biliary drainage/stenting, covered metallic stents, gastrointestinal stenting or surgical gastrojejunostomy in selected contexts, and multidisciplinary palliative/supportive care[14]Standard option (per International Journal of Clinical Oncology / Japan Pancreas Society)not biomarker-specific; obstructive jaundice, gastrointestinal obstruction, and advanced pancreatic cancer supportive-care contexts. · These are symptom/anatomy-specific supportive options. Procedure choice depends on anatomy, prognosis, local expertise, and patient goals. Confidence/conflicts: high for guideline support; no conflict identified.
  • gemcitabine hydrochloride plus nab-paclitaxel[14]Standard option (per International Journal of Clinical Oncology / Japan Pancreas Society)not biomarker-specific; first-line chemotherapy for pancreatic cancer with distant metastases. · This is guideline support, not a patient-specific regimen selection. Adverse effects, neuropathy risk, performance status, and local coverage require confirmation. Confidence/conflicts: high for guideline recommendation; no conflict identified.
  • olaparib (Lynparza)[15]PMDA-approved (Japan)BRCA mutation-positive; maintenance after chemotherapy including platinum-based antineoplastic drugs. · PMDA review report confirms the indication text in the label context; exact current package insert, companion diagnostic requirements, and insurance criteria should be checked in Japan. Confidence/conflicts: high for indication existence using PMDA review text; current-label and reimbursement details remain follow-up gaps. No conflict identified.
  • radiotherapy or chemoradiotherapy approaches, including fluoropyrimidine or gemcitabine with radiotherapy in locally advanced unresectable disease and radiotherapy for painful bone metastases[14]Standard option (per International Journal of Clinical Oncology / Japan Pancreas Society)not biomarker-specific; locally advanced unresectable pancreatic cancer scheduled for chemoradiotherapy; painful bone metastases in advanced disease; selected recurrence contexts. · The guideline distinguishes settings and recommendation strengths; radiotherapy is not described as universal for all PDAC. Local radiation expertise and goals of care matter. Confidence/conflicts: high for guideline support by setting; no conflict identified.

Russia

  • FOLFIRINOX-type chemotherapy; gemcitabine plus albumin-bound paclitaxel; gemcitabine monotherapy in less-fit patients; platinum-containing combinations in BRCA/PALB2 contexts[16]Standard option (per MedElement clinical recommendations portal)BRCA or PALB2 mutation status affects platinum-containing regimen preference in source; Preoperative/induction therapy for borderline resectable or unresectable non-metastatic disease; first-line metastatic therapy; less-fit metastatic contexts. · Regimen choice depends on ECOG/performance status, renal and liver function, tumor complications, age, comorbidities, and toxicity risks. This entry does not establish reimbursement or brand-specific availability. Confidence/conflicts: Medium-high for guideline role; reimbursement and individual access source-pending. Primary source is in Russian. English summary pending human review — confirm exact wording with your care team.
  • Pancreatic enzyme replacement, glucose monitoring/correction, biliary drainage when obstructive jaundice requires minimally invasive drainage, rehabilitation and symptom-directed supportive care[16]Standard option (per MedElement clinical recommendations portal)Not biomarker-selected; Postoperative and advanced-disease supportive-care contexts. · Supportive care depends on symptoms, nutrition, endocrine status, obstruction, infection, and access to gastroenterology, endocrinology, rehabilitation, and interventional endoscopy/radiology. Confidence/conflicts: Medium-high for supportive guideline content; product availability and individualized need not inferred. Primary source is in Russian. English summary pending human review — confirm exact wording with your care team.
  • Radiation therapy or chemoradiation only in selected study/individualized contexts; continuation or maintenance chemotherapy when unresectability persists[16]Standard option (per MedElement clinical recommendations portal)Not biomarker-selected; Borderline resectable or unresectable non-metastatic pancreatic cancer after induction therapy assessment. · This is a cautionary guideline cell: it records a restricted/non-routine role for radiation rather than routine availability. Decisions depend on restaging, response, tolerability, and clinical-trial access. Confidence/conflicts: Medium-high for guideline restriction; local clinical-trial options not established. Primary source is in Russian. English summary pending human review — confirm exact wording with your care team.
  • Radiation therapy or chemoradiation only in selected study/individualized contexts; continuation or maintenance chemotherapy when unresectability persists[16]Standard option (per MedElement clinical recommendations portal)Not biomarker-selected; Borderline resectable or unresectable non-metastatic pancreatic cancer after induction therapy assessment. · This is a cautionary guideline cell: it records a restricted/non-routine role for radiation rather than routine availability. Decisions depend on restaging, response, tolerability, and clinical-trial access. Confidence/conflicts: Medium-high for guideline restriction; local clinical-trial options not established. Primary source is in Russian. English summary pending human review — confirm exact wording with your care team.
  • Surgical treatment, including resection approaches appropriate to tumor location, with perioperative or adjuvant chemotherapy context[17]Standard option (per MedElement clinical recommendations portal)Not biomarker-selected; Resectable stage I-III contexts; perioperative/adjuvant settings as described by the guideline. · Resectability depends on vascular involvement, metastatic evaluation, CA 19-9 and other risk factors, performance status, surgical expertise, and multidisciplinary review. Russian-language clinical text requires human review. Confidence/conflicts: Medium-high for Russian guideline content; center-level access and Ministry-hosted original remain follow-up gaps. Primary source is in Russian. English summary pending human review — confirm exact wording with your care team.
  • Surgical treatment, including resection approaches appropriate to tumor location, with perioperative or adjuvant chemotherapy context[17]Standard option (per MedElement clinical recommendations portal)Not biomarker-selected; Resectable stage I-III contexts; perioperative/adjuvant settings as described by the guideline. · Resectability depends on vascular involvement, metastatic evaluation, CA 19-9 and other risk factors, performance status, surgical expertise, and multidisciplinary review. Russian-language clinical text requires human review. Confidence/conflicts: Medium-high for Russian guideline content; center-level access and Ministry-hosted original remain follow-up gaps. Primary source is in Russian. English summary pending human review — confirm exact wording with your care team.

Thailand

  • Pegylated liposomal irinotecan (Onivyde) with fluorouracil and leucovorin[18]ApprovedUGT1A1 status is a safety/pharmacogenetic consideration in the source; not a tumor-selection biomarker; After progression following gemcitabine-based therapy in metastatic pancreatic adenocarcinoma. · Thai NDI prescribing document supports indication text but does not establish reimbursement, formulary access, or center availability. Source warns that liposomal irinotecan is not interchangeable with non-liposomal irinotecan; toxicity monitoring is described in the label. Confidence/conflicts: High for Thai NDI prescribing-document indication; reimbursement not established.

Sources

  1. National Cancer Institute (NCI) — national cancer agency evidence summary · national cancer agency evidence summary
  2. U.S. Food and Drug Administration (FDA) — drug label / prescribing information · drug label / prescribing information
  3. U.S. Food and Drug Administration (FDA) — drug label / prescribing information · drug label / prescribing information
  4. U.S. Food and Drug Administration (FDA) — regulator accelerated approval notice · regulator accelerated approval notice
  5. European Medicines Agency (EMA) — regulator EPAR · regulator EPAR
  6. Haute Autorité de Santé (HAS) — national HTA/reimbursement opinion · national HTA/reimbursement opinion
  7. European Medicines Agency (EMA) — regulator EPAR · regulator EPAR
  8. Haute Autorité de Santé (HAS) — national HTA/reimbursement opinion · national HTA/reimbursement opinion
  9. Gemeinsamer Bundesausschuss (G-BA) — national benefit assessment justification / courtesy translation · national benefit assessment justification / courtesy translation
  10. Haute Autorité de Santé (HAS) — national HTA/reimbursement opinion index · national HTA/reimbursement opinion index
  11. National Institute for Health and Care Excellence (NICE) — national guideline · national guideline
  12. National Institute for Health and Care Excellence (NICE) — technology appraisal / Cancer Drugs Fund recommendation · technology appraisal / Cancer Drugs Fund recommendation
  13. National Institute for Health and Care Excellence (NICE) — technology appraisal guidance · technology appraisal guidance
  14. International Journal of Clinical Oncology / Japan Pancreas Society — peer-reviewed English guideline synopsis · peer-reviewed English guideline synopsis
  15. Pharmaceuticals and Medical Devices Agency (PMDA) — regulator review report · regulator review report
  16. MedElement clinical recommendations portal — Russian clinical guideline mirror / chemotherapy recommendations · Russian clinical guideline mirror / chemotherapy recommendations
  17. MedElement clinical recommendations portal — Russian clinical guideline mirror / treatment recommendations · Russian clinical guideline mirror / treatment recommendations
  18. Thai National Drug Information / Thai FDA-MOPH — prescribing information PDF / regulator drug-information repository · prescribing information PDF / regulator drug-information repository

This is official regulatory and access status only — not medical advice, not a recommendation, and not a statement about eligibility. Whether any option fits depends on your situation and your oncology team. Status changes over time; confirm the current position with the linked source. Last checked 2026-06-12.

Beyond approved care

In clinical trials & emerging options

Options that are not — or not yet — an approved standard where you live: studies, clinical trials, off-label use, and early evidence that your own oncologist may not raise. Each is labeled by how strong the evidence is. A listing here is information to research and discuss with your team; it does not mean a treatment is proven, safe for you, or available today.

In clinical trials

A clinical-trial listing or early report shows an option is being studied — not that it works, that it is safe for any one person, or that a site is enrolling today. Whether any of these fits is a conversation for your oncology team and the trial team. Last checked 2026-06-12.