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Review
. 2019 Sep 25:11:1758835919875568.
doi: 10.1177/1758835919875568. eCollection 2019.

An update on treatment options for pancreatic adenocarcinoma

Aurélien Lambert  1 , Lilian Schwarz  2 , Ivan Borbath  3 , Aline Henry  4 , Jean-Luc Van Laethem  5 , David Malka  6 , Michel Ducreux  6 , Thierry Conroy  7
Affiliations
Review

An update on treatment options for pancreatic adenocarcinoma

Aurélien Lambert et al. Ther Adv Med Oncol. .

Abstract

Pancreatic cancer is one of the most lethal solid organ tumors. Due to the rising incidence, late diagnosis, and limited treatment options, it is expected to be the second leading cause of cancer deaths in high income countries in the next decade. The multidisciplinary treatment of this disease depends on the stage of cancer at diagnosis (resectable, borderline, locally advanced, and metastatic disease), and combines surgery, chemotherapy, chemoradiotherapy, and supportive care. The landscape of multidisciplinary pancreatic cancer treatment is changing rapidly, especially in locally advanced disease, and the number of treatment options in metastatic disease, including personalized medicine, innovative targets, immunotherapy, therapeutic vaccines, adoptive T-cell transfer, or stemness inhibitors, will probably expand in the near future. This review summarizes the current literature and provides an overview of how new therapies or new therapeutic strategies (neoadjuvant therapies, conversion surgery) will guide multidisciplinary disease management, future clinical trials, and, hopefully, will increase overall survival.

Keywords: FOLFIRINOX; adjuvant chemotherapy; borderline pancreatic cancer; guidelines; pancreatic cancer; supportive care; surgery.

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Conflict of interest statement

Conflict of interest statement: D.M. reports personal fees and nonfinancial support from Amgen, Bayer, Merck Serono, MSD, Roche, Sanofi, and Servier, personal fees from Shire, Halio Dx, Agios, and Pierre Fabre Oncologie, outside the submitted work; M.D. reports personal fees and nonfinancial support from Roche, MSD, Amgen, personal fees from Merck Serono, Bayer, Ipsen, Lilly, Servier, HalioDX, Sanofi outside the submitted work. The other authors declare that they have no conflict of interest.

Figures

Figure 1.
Figure 1.
Proposed algorithm for choice of first- and second-line chemotherapy in metastatic pancreatic cancer. 5-FU, 5-fluorouracil; BSC, best supportive care; dMMR, deficient mismatch repair; MSI, microsatellite instability; PS, performance status; ULN, upper limit of normal range.
See this image and copyright information in PMC

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