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4 standard-of-care settings across 3 lines and 3 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Localised | Segmental resection with en bloc lymphadenectomy; pancreatoduodenectomy for duodenal tumours not amenable to segmental resection. | NCCN · Category 2A | - |
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Adjuvant (stage III; selected stage II) | Fluoropyrimidine with oxaliplatin (CAPOX or FOLFOX) for six months, extrapolated from colon cancer; BALLAD is the randomised test. | NCCN · Category 2A | 82 |
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| MSI-H / dMMR | Advanced, MSI-high / dMMR | Pembrolizumab first line (tumour-agnostic approval; ZEBRA and KEYNOTE-158 cohorts). | NCCN · Category 2A (preferred) | 98 | |
| pMMR / MSS | Advanced, MSS | CAPOX or FOLFOX first line; taxane- or irinotecan-based second line; HER2-directed therapy in trials; clinical trial enrolment encouraged. | NCCN Guidelines: Small Bowel Adenocarcinoma | 82 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.