NICE has recommended that:
- People with advanced or metastatic (when the cancer has spread to other parts of the body) pancreatic cancer may be treated with gemcitabine as a first line treatment if they have a Karnofsky performance score of 50 or more.
- Karnofsky is a measure given by a health professional to a person's ability to perform certain ordinary tasks: 100 = normal, no complaints, 70 = unable to carry on normal activity, 50 = requires considerable assistance, 40 = disabled, 30 =hospitalisation recommended.
- Gemcitabine should not be used for people with pancreatic cancer who are suitable for surgery that may cure their cancer, or those who have a Karnofsky performance score of less than 50.
- Gemcitabine should not be used as a second line treatment for people with pancreatic cancer, because there is insufficient evidence to support this practice.
The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.