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Review
. 2014 Mar 7;20(9):2352-7.
doi: 10.3748/wjg.v20.i9.2352.

Optimum chemotherapy in the management of metastatic pancreatic cancer

Marwan Ghosn  1 , Hampig Raphael Kourie  1 , Fadi El Karak  1 , Colette Hanna  1 , Joelle Antoun  1 , Dolly Nasr  1
Affiliations
Review

Optimum chemotherapy in the management of metastatic pancreatic cancer

Marwan Ghosn et al. World J Gastroenterol. .

Abstract

Pancreatic cancer is one of the most devastating solid tumors, and it remains one of the most difficult to treat. The treatment of metastatic pancreatic cancer (MPC) is systemic, based on chemotherapy or best supportive care, depending on the performance status of the patient. Two chemotherapeutical regimens have produced substantial benefits in the treatment of MPC: gemcitabine in 1997; and FOLFIRIONOX in 2011. FOLFIRINOX improved the natural history of MPC, with overall survival (OS) of 11.1 mo. Nab-paclitaxel associated with gemcitabine is a newly approved regimen for MPC, with a median OS of 8.6 mo. Despite multiple trials, this targeted therapy was not efficient in the treatment of MPC. Many new molecules targeting the proliferation and survival pathways, immune response, oncofetal signaling and the epigenetic changes are currently undergoing phase I and II trials for the treatment of MPC, with many promising results.

Keywords: Chemotherapy; Evolution; Metastatic pancreatic cancer; Recent therapies; Targeted therapy.

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Figures

Figure 1
Figure 1
A schema representing the approved treatment for metastatic pancreatic cancer in patients having poor or good performance status.
See this image and copyright information in PMC

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