title: New treatment options for advanced pancreatic cancer.
abstract: Pancreatic cancer has a very high mortality rate and affects approximately 230,000 individuals worldwide. Gemcitabine has become established as the standard therapy for advanced pancreatic cancer; however, the survival advantage is small. Adjuvant chemotherapy using either 5-fluorouracil or gemcitabine is now established in pancreatic cancer as an alternative therapy. Combinations of gemcitabine with either platin agents or capecitabine may be advantageous. Anti-EGFR and anti-VEGF agents have been unsuccessful but multiple tyrosine kinase inhibitors are under investigation. Of the increasing number of immunological agents, the GV1001 antitelomerase vaccine holds some interest. Targeted agents against important mitogenic pathways, including MEK/ERK, Src, PI3K/Akt, mTOR, Hedgehog and NF-kappaB, as well as agents targeting histone deacetylase, poly(ADP-ribose) polymerase, heat shock protein 90 and other agents such as beta-lapachone, hold considerable interest for further development. However, the probability of individual success is low.
authors.affiliation: Royal Surrey County Hospital NHS Trust, Egerton Road, Guildford, GU2 7XX, UK. gmiddleton@royalsurrey.nhs.uk
authors.forename: Gary
authors.initials: G
authors.lastname: Middleton
authors.forename: Paula
authors.initials: P
authors.lastname: Ghaneh
authors.forename: Eithne
authors.initials: E
authors.lastname: Costello
authors.forename: William
authors.initials: W
authors.lastname: Greenhalf
authors.forename: John P
authors.initials: JP
authors.lastname: Neoptolemos
mesh_terms: D017024:Chemotherapy, Adjuvant / Q000639:trends*; D018450:Disease Progression; D006801:Humans; D007167:Immunotherapy / Q000639:trends*; D010190:Pancreatic Neoplasms / Q000628:therapy*; D018714:Radiotherapy, Adjuvant / Q000639:trends; D014612:Vaccines / Q000627:therapeutic use
chemical_list: D014612:Vaccines