title: Metastatic pancreatic cancer: is gemcitabine still the best standard treatment? (Review).
abstract: Pancreatic ductal adenocarcinoma is the fourth cause of death in the Western world. Surgery remains the only treatment offering an advantage in terms of overall survival (5-year survival range, 15-25%), but unfortunately only 10-20% of patients present resectable disease at the time of diagnosis. Hence chemotherapy, possibly combined with radiation therapy, remains the only treatment option aimed at palliation of symptoms and ensuring a better quality of life. Notwithstanding the efforts to find more effective therapies for the treatment of pancreatic cancer, significant results have not yet been achieved. Increasing interest has focused on integrated treatments, i.e. chemotherapy combined with targeted therapies, and a better selection of patients. This study examines the principal clinical trials that will help give clinicians an overview of the progress made in the systemic therapy for advanced pancreatic cancer patients in recent years.
authors.affiliation: L. e A. Seràgnoli Department of Hematology and Oncological Sciences, S. Orsola-Malpighi Hospital, University of Bologna, I-40138 Bologna, Italy. mariacristina.dimarco@unibo.it
authors.forename: Mariacristina
authors.initials: M
authors.lastname: Di Marco
authors.forename: Roberto
authors.initials: R
authors.lastname: Di Cicilia
authors.forename: Marina
authors.initials: M
authors.lastname: Macchini
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Nobili
authors.forename: Silvia
authors.initials: S
authors.lastname: Vecchiarelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Brandi
authors.forename: Guido
authors.initials: G
authors.lastname: Biasco
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D021441:Carcinoma, Pancreatic Ductal / Q000188:drug therapy* / Q000378:metabolism / Q000556:secondary; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage; D018714:Radiotherapy, Adjuvant; D015398:Signal Transduction / Q000187:drug effects; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors / Q000378:metabolism; D000093542:Gemcitabine
chemical_list: D020533:Angiogenesis Inhibitors; D000964:Antimetabolites, Antineoplastic; D047428:Protein Kinase Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D003841:Deoxycytidine; D005472:Fluorouracil; D000093542:Gemcitabine