Chemotherapy for pancreatic cancer: the rise of multidrug regimens.

The last decade has seen a humble king lose its throne. During 15 years of undivided rule, gemcitabine monotherapy, which is modestly active in the first-line treatment of metastatic pancreatic cancer, proved to be superior to all its challengers (largely gemcitabine plus another drug), until it was supplanted by a two-drug regimen (gemcitabine plus nab-paclitaxel), 1 and then a three-drug, gemcitabine-free, regimen (FOLFIRINOX [folinic acid, fluorouracil, irinotecan, and oxaliplatin]). 2 More recently, gemcitabine lost its crown in the adjuvant setting, again against a two-drug regimen (gemcitabine plus capecitabine) 3 and a three-drug regimen (modified FOLFIRINOX) [...