Certainly, we are now seeing more patients receiving second-line treatment. As for the numbers, if you are working in an academic institution, you are seeing more second-line treatment, and in my opinion, probably more than 50%. Whereas in the community setting, I think that number is a bit lower because of the type of patients and use of a different treatment approach. Second-line treatment options depend on what patients received in the front line, and that is how we make the decision for the second line. We also take into account performance status, and we look at some residual side effects that may affect the choice of treatment. If someone received chemotherapy up front and then had significant neurotoxicity, we possibly have to be careful in using a drug that causes neurotoxicity. Obviously, here we have only 2 drugs we are dealing with: liposomal irinotecan or nab-paclitaxel, which can cause neuropathy.

 In second-line patients who receive gemcitabine + nab-paclitaxel as front-line therapy, second-line therapy will be based on treatment tolerability and specific patient characteristics, with liposomal irinotecan combined with 5-FU/leucovorin or FOLFIRINOX both being good clinical options for second-line therapy. In patients who receive FOLFIRINOX as front-line, they would receive gemcitabine + nab-paclitaxel as second-line, with liposomal irinotecan + 5-FU/leucovorin as a third-line option, if they do not have any significant neuropathy and are well enough to receive the combination treatment.