Chemotherapy for pancreatic cancer

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. It is one of the most common treatments for pancreatic cancer.

What is chemotherapy?

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. It is one of the most commonly used treatments for pancreatic cancer.

We have more general information about having chemotherapy.

Chemotherapy to treat pancreatic cancer

You may have chemotherapy:

  • after surgery, to reduce the chance of the cancer coming back – this is called adjuvant chemotherapy
  • to shrink the cancer, relieve symptoms and prolong life if surgery is not possible – this is called palliative chemotherapy
  • to shrink a cancer before surgery – this is called neo-adjuvant chemotherapy.

Sometimes, you may have chemotherapy with radiotherapy. This is called chemoradiation. If you have chemotherapy with radiotherapy before surgery, it is called neo-adjuvant chemoradiation. This may be part of a cancer research trial. Your doctor or specialist nurse can give you more information about chemoradiation.

Chemotherapy after surgery

You may have chemotherapy after an operation to remove the cancer. The chemotherapy usually starts within 3 months of the operation and lasts about 6 months.

The most commonly used chemotherapy treatments are:

Another drug that may be used is fluorouracil (5FU). You will have this as a drip (infusion) into a vein.


You have gemcitabine as a drip into a vein over 30 minutes. You will usually have this once a week for 3 weeks. You will then have a week of rest. These 4 weeks make up a cycle of treatment.


You have capecitabine as tablets, twice a day. You should swallow them whole with a glass of water. You need to take them within 30 minutes after eating a meal.

You usually take the tablets every day for 2 weeks. This is then followed by a week of no tablets. These 3 weeks make up a cycle of treatment.


If you are having gemcitabine and capecitabine together (GemCap), each cycle usually takes 4 weeks. You have a drip of gemcitabine once a week for 3 weeks and also take the tablets for 3 weeks. Then you will have no treatment in week 4.


Sometimes, you may have a combination of drugs called FOLFIRINOX. It combines:

  • folinic acid (leucovorin or calcium folinate)
  • fluorouracil (5FU)
  • irinotecan (Campto®)
  • oxaliplatin.

Folinic acid is not a chemotherapy drug. But you may have it with 5FU, as it has been shown to make 5FU work better.

FOLFIRINOX can cause more side effects because it contains 3 chemotherapy drugs. It is only suitable for people who are well enough to cope with these side effects.

Each cycle of treatment lasts 2 weeks. Your doctor or nurse will tell you more about this and how many cycles you will likely have. You may have a PICC line put into a vein to have this treatment.


Chemotherapy for advanced pancreatic cancer

People with advanced pancreatic cancer may have treatment with a single chemotherapy drug. Or they may have 2 or 3 combined. Common treatments are:

Your doctor will talk to you about what drugs are available and suitable for you.. 

Gemcitabine and nab-paclitaxel (Abraxane®)

You will have both gemcitabine and nab-paclitaxel as drips into a vein. The treatment usually takes half an hour. You will have it once a week for 3 weeks. This will be followed by a rest week. These 4 weeks make up a cycle of treatment. Your doctor or nurse will tell you more about this and how many cycles you will likely have.

Other drugs

Cancer research trials aim to improve the results of treatment for pancreatic cancer. Your doctor or nurse may talk to you about research trials if there is one suitable for you.

Sometimes research trials may use new drugs or drug combinations to treat pancreatic cancer. Sometimes the research trials may look at different ways of using existing treatments to see if they can be more effective.

Some research trials are looking at drug treatments called targeted therapy and immunotherapy for pancreatic cancer.

Targeted therapy drugs interfere with the way cancer cells grow.

Olaparib is a type of targeted therapy called a PARP inhibitor. It is used to treat cancer of the pancreas that has a genetic change in the cancer cells called BRCA 1 or BRCA 2. It might be used after chemotherapy.

Immunotherapy tries to trigger the body’s immune system to attack cancer cells. The body’s immune system fights infection and disease. Immunotherapy is not yet widely used for pancreatic cancer.

How chemotherapy is given

You usually have chemotherapy as an outpatient. Most drugs are given into a vein (intravenously). You take some drugs (such as capecitabine) as tablets.

You may have drugs through:

  • a short, thin tube the nurse puts into a vein in your arm or hand (cannula)
  • a fine tube that goes under the skin of your chest and into a vein close by (central line)
  • a fine tube that is put into a vein in your arm and goes up into a vein in your chest (PICC line)
  • an implantable port.

Watch our videos about chemotherapy treatment centres and some of the different health professionals you will meet.

Learn how PICC lines and central lines are put in.

Side effects of chemotherapy

Chemotherapy drugs may cause some unpleasant side effects, but they can also make you feel better. This is because they relieve the symptoms caused by the cancer.

Most people have some side effects, but they can usually control these with medicines. The side effects usually go away once treatment has finished. Treatment with a combination of chemotherapy drugs may have more severe side effects than a single chemotherapy drug. You can talk to your doctor or nurse about what to expect from your treatment.

About our information

  • References

    Below is a sample of the sources used in our pancreatic cancer information. If you would like more information about the sources we use, please contact us at

    European Society for Medical Oncology, Cancer of the pancreas: ESMO clinical Practice Guidelines. Volume 26, Supplement 5, V56-V68, 1 September 2015. Available from: (accessed May 2021).

    National Institute for Health and Care Excellence. Pancreatic cancer in adults: diagnosis and management. NICE guideline (NG85). Published 7 February 2018. Available at: (accessed May 2021).

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Chief Medical Editor, Professor Tim Iveson, Consultant Medical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

Date reviewed

Reviewed: 05 January 2022
Next review: 05 January 2025
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

Our cancer information meets the PIF TICK quality mark.

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