Drug therapies for pancreatic cancer

Chemotherapy

Chemotherapy uses drugs to kill or slow the growth of cancer cells. It is used for pancreatic cancer at various stages. If the cancer is at a stage where it can be removed with surgery, chemotherapy is often used before or after the surgery.

When surgery cannot remove the cancer, chemotherapy can be used as a palliative treatment to slow the growth of the cancer and relieve symptoms. For some stage 3 cancers, chemotherapy may be combined with radiation therapy. This is called chemoradiation.

The chemotherapy drugs are usually given as a liquid through a drip inserted into a vein in the arm (intravenous infusion) or as tablets that you swallow. To avoid damaging the veins in your arm, it may also be given through a tube implanted into a vein (called a port, catheter, central line or PICC line). This will stay in place until all your chemotherapy treatment is over.

You will usually receive treatment as an outpatient (not admitted to hospital). Typically, you will have several courses of treatment, with rest periods of a few weeks in between. Your medical oncologist will assess how the treatment is working based on your symptoms and wellbeing, as well as scans and blood tests. Tell your team about any prescription, over-the-counter or natural medicines you are taking, as these may affect how the chemotherapy works in your body.

I found chemo a bit daunting – walking into the room with the chairs lined up. But the nurses talked through it with me so I knew what to expect.

Cheryl

Side effects of chemotherapy

Chemotherapy can affect healthy cells in the body, which may cause side effects. Some people have few side effects, while others have many. The side effects will depend on the drugs used and the dose. Your medical oncologist and chemotherapy nurses will explain the possible side effects to you, the best ways to manage them and who to contact if you need support.

Side effects of chemotherapy may include:

• feeling very tired (fatigue)
• feeling sick (nausea)
• vomiting
• mouth ulcers and skin rashes
• hair loss
• diarrhoea or constipation
• flu-like symptoms such as fever, headache and muscle soreness
• poor appetite.

Chemotherapy can also affect the number of cells in your blood. Fewer white blood cells can mean you are more likely to catch infections. Fewer red blood cells (anaemia) can leave you weak and breathless.

Most chemotherapy side effects are temporary and can be managed, so discuss how you are feeling with your treatment team. If you are having chemotherapy as a palliative treatment, your treatment team will help you weigh up the benefits of improving your cancer symptoms against any side effects the chemotherapy is causing.

Targeted therapy and immunotherapy

Other cancer drug treatments include targeted therapy and immunotherapy.

Targeted therapy targets specific features of cancer cells to stop the cancer growing and spreading, while immunotherapy uses the body’s own immune system to fight cancer.

In Australia, as of March 2026, only one targeted therapy drug (olaparib) is approved for use for pancreatic cancer. It is only suitable for a small number of people. This drug has been shown to provide some benefit for people with metastatic pancreatic cancer who have the BRCA gene changes. Your doctors will be able to provide the latest information about its availability.

So far, no other targeted therapy and immunotherapy drugs have been found to be effective in pancreatic cancer, but research is continuing.

Talk to your doctor about whether a clinical trial is an option for you.