<prompt> Drug of choice for palliative treatment of pancreatic carcinomaErlotinibGemcitabinePaclitaxelCyclophosphomide  <response>: Ans. is b a c i.e. Gemcitabin Erlotinib Paclitaxel Treatment for Inoperable pancreatic cancerA Inoperable locally advanced disease Approximately 30 of patients present with locally advanced unresectable but nonmetastatic pancreatic carcinoma. Gemcitabine is used a the treatment of choice for these patients. The median survival with gemcitabine is 9 months, and patients who respond to or achieve stable disease after 3-6 months of gemcitabine may derive benefit from consolidation radiotherapy.B Metastatic Disease Approximately 60 of patients with pancreatic cancer present with metastatic disease. Gemcitabine is the standard treatment with a median survival of 6 months and a 1-year survival rate of only 20. The combination of erlotinib, oral HER1EGFR tyrosine kinase inhibitor with gemcitabine resulted in an improved 1-year survival compared with gemcitabine alone 23 versus 17, p 0.023. Capecitabine, an oral fluoropyrimidine, has been combined with gemcitabine GEM-CAP in a phase III trial that showed an improvement in response rate and progression-free survival over single-agent gemcitabine, but no survival benefit. A trial in good performance status patients with metastatic pancreatic cancer showed improved survival with the combination of 5FUFA, irinotecan and oxaliplatin FOLFIRINOX compared with gemcitabine, but with increased toxicity. Nab-paclitaxel Abraxane, an albumin bound nano-particle formulation of paclitaxel, given with gemcitabine also shows promising activity. 