The 14-EISCP starts with the end of visit 1:

• The investigator must determine which procedures have to be undertaken within the following 14 days (+/- 2 days):
• Pain management,
• Nutritional management,
• Pathological examination and site of biopsy,
• Imaging,
• Endoscopy for diagnosis purpose or for biliary/duodenal stenting.

At the end of the visit the investigator must plan all the supportive care and procedures indicated for the patient and indicate those within a specific form

The 14-EISCP starts with the end of the first visit medical for patients who have symptoms suspicious of or confirmed symptomatic aPDAC (ECOG PS ≥ 2 and/or initially ineligible for clinical trial, FOLFIRINOX or gemcitabine + nab-paclitaxel):

The The 14-EISCP will include:

• Pain management,
• Nutritional management,
• Pathological examination and site of biopsy,
• Imaging,
• Endoscopy for diagnosis purpose or for biliary/duodenal stenting.

After the 14-EISCP, patients will receive best supportive care or chemotherapy according to their ECOG PS status:

• ECOG-PS 0-1 and eligible for clinical trial, FOLFIRINOX or gemcitabine + nab-paclitaxel Patient will be treated by : FOLFIRINOX or gemcitabine-nab-paclitaxel or clinical trial
• ECOG-PS 2-4 and / or ineligible for clinical trial, FOLFIRINOX or gemcitabine + nab-paclitaxel Patients will be treated by: FOLFOX7 lightened

The success is determined by:

Program Feasibility :

The 14-EISCP is considered feasible if the planned procedures, established during the initial consultation with the investigator, is completed within 14 days (+/- 2 days) following the first consultation, or before the start of chemotherapy if it started within 14 days.

and

Clinical Benefit at 30 days post-consultation defined by one of the following criteria:

1. An improvement of ECOG PS from ≥2 to 1 or 0.
2. A ≥5-point improvement in either fatigue, pain, or global health, as measured by the QLQ-C15-PAL, with no worsening in ECOG PS or the dimensions of fatigue, pain, and global health compared to baseline values.
3. The initiation of chemotherapy within 30 days of consultation.

If none of the above criteria (1), (2), or (3) are met, the clinical benefit was considered absent, and the outcome was classified as a failure.

The success of the 14-EISCP was defined by success of both criteria.

Delay between first medical appointment and beginning of chemotherapy in days.