Updates in pancreatic cancer: Modest gains and hopeful targets

J Oncol Pharm Pract. 2019 Jan;25(1):101-109. doi: 10.1177/1078155218763035. Epub 2018 Mar 26.

Abstract

Pancreatic cancer is the twelfth most common cancer in the United States, representing 3.2% of all new cancer cases. While composing a small percentage of cancer diagnoses, pancreatic cancer is amongst the most lethal carcinomas, with an overall 5-year survival of 8.2% and incidence rates almost equivocal to death rates. By the time of diagnosis, a majority of patients will present with advanced stage disease. For patients with resectable disease, the estimated overall survival (OS) remains low at 20% as most will develop metastatic disease within 5 years. The lethality of this cancer is attributed to several factors including delayed presentation, lack of effective screening, and complex tumor biology and genetics. Data also suggest that even upon early presentation, pancreatic cancer is a systemic disease with micrometastasis present in the early stages. Traditional cytotoxic therapies have not been clinically impactful in pancreatic cancer, especially in advanced stages, and very little headway has been made in the development of new targeted therapies. As such, this review will discuss current advances in standard of care treatments and novel drug targets being researched.

Keywords: FOLFIRINOX; PARPi; gemcitabine; pancreatic cancer.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Clinical Trials as Topic / methods
  • Drug Combinations
  • Drug Delivery Systems / methods*
  • Drug Delivery Systems / trends
  • Fluorouracil / administration & dosage
  • Humans
  • Immunotherapy / methods
  • Immunotherapy / trends
  • Irinotecan
  • Leucovorin / administration & dosage
  • Neoplastic Stem Cells / transplantation
  • Organometallic Compounds / administration & dosage
  • Oxaliplatin
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / drug therapy*
  • Pancreatic Neoplasms / mortality

Substances

  • Antineoplastic Agents
  • Drug Combinations
  • Organometallic Compounds
  • folfirinox
  • Oxaliplatin
  • Irinotecan
  • Leucovorin
  • Fluorouracil