Insights from ASCO 2025: What’s Next for Pancreatic Cancer?

Paul E. Oberstein, MD; Priyadarshini Pathak, MBBS; and Tara E. Seery, MD, discuss how to optimize treatment decisions for patients with pancreatic cancer by comparing NALIRIFOX vs modified FOLFIRINOX regimens, sequencing therapies from first to second line, managing toxicities through dose modifications to maintain patients on treatment longer, and the promising pipeline of emerging targeted therapies including KRAS inhibitors and immunotherapy combinations presented at ASCO 2025.

EP. 1: Expert Perspectives: 55-Year-Old Woman Presenting With Locally Advanced Pancreatic Cancer: Next Steps

June 30th 2025

Panelists discuss how to approach a 55-year-old woman with locally advanced pancreatic cancer involving portal vein invasion, emphasizing the importance of staging, performance status assessment, and systemic chemotherapy as first-line treatment.

EP. 2: Locally Advanced Pancreatic Cancer: Treatment Approaches and Regimen Selection

June 30th 2025

Panelists discuss how treatment decisions for locally advanced pancreatic cancer should consider systemic therapy followed by radiation, with triplet regimens preferred for younger patients with good performance status, while acknowledging the limited evidence base requiring extrapolation from metastatic data.

EP. 3: mPDAC: Historical Milestones and Selecting the Right First-Line Regimen

July 9th 2025

Panelists discuss how the evolution of pancreatic cancer treatment has progressed since 2011 with key trials like PRODIGE-4 (FOLFIRINOX) and NAPOLI-3 (NALIRIFOX), and how clinicians choose between regimens based on patient characteristics and adverse effect profiles.

EP. 4: Aligning Goals in mPDAC: Shared Decision-Making in First-Line Therapy

July 9th 2025

Panelists discuss how patient choice and long-term toxicity considerations, particularly neuropathy differences between NALIRIFOX and FOLFIRINOX, influence treatment decisions while managing patient expectations about stable disease being a positive outcome.

EP. 5: NAPOLI 3 Trial Deep Dive: ASCO 2025 Updated OS Analysis

July 16th 2025

Panelists discuss how the PRODIGE-4 and NAPOLI-3 trials differed in patient populations, age limits, and comparator arms, leading to similar regimens with dosage modifications that have become standard practice.

EP. 6: FFX (or mFFX) vs NALIRIFOX: Managing Toxicity and Genetic (UGT1A1*28) Dose Considerations in mPDAC

July 16th 2025

Panelists discuss how recent ASCO data showed long-term responders on NALIRIFOX were younger, fitter patients with lower disease burden who could tolerate treatment longer, reinforcing the strategy of dose modifications to maintain patients on therapy.

EP. 7: mPDAC Frontline Therapy: Real-World Evidence and Emerging Trial Data From ASCO 2025

July 23rd 2025

Panelists discuss how NALIRIFOX differs from modified FOLFIRINOX primarily in lower neuropathy rates due to reduced oxaliplatin dosing, higher diarrhea rates, and lower neutropenia, while UGT1A1 testing is generally not required up front.

EP. 8: Comparing FFX (or mFFX) and Gem-NabP: What Clinical Practice Tells Us

July 23rd 2025

Panelists discuss how real-world data suggest similar efficacy between NALIRIFOX and FOLFIRINOX, and how sequential therapy approaches using doublets don’t appear superior to up-front triplet regimens for appropriate patients.

EP. 9: Sequencing mPDAC Therapy Beyond First Line: Clinical and Patient-Centered Strategies

July 30th 2025

Panelists discuss how second-line therapy sequencing involves using the backbone not received in first-line (5-FU or gemcitabine-based), with increased emphasis on quality of life discussions and the importance of early tumor sequencing for potential targeted therapies.

EP. 10: NAPOLI: Using Liposomal Irinotecan (with 5-FU/LV) in the Second-Line Setting in mPDAC and Beyond

July 30th 2025

Panelists discuss how the NAPOLI-1 trial established 5-FU/leucovorin plus liposomal irinotecan as the standard second-line therapy for patients who received gemcitabine-based first-line treatment, though patient selection remains challenging.