title: Management strategies in pancreatic cancer.
abstract: OBJECTIVE
  Current first-line and adjuvant chemotherapeutic strategies for management of patients with pancreatic cancer are reviewed.
  
  
  CONCLUSIONS
  Pancreatic adenocarcinoma is the 10th most prevalent cancer and the fourth most common cause of cancer deaths in the United States. More than 80% of patients with pancreatic cancer are diagnosed with locally advanced or metastatic disease and are not candidates for surgery; these patients often require multimodal treatment. The most widely used chemotherapy for such patients, as well as patients requiring adjuvant therapy after surgery, is gemcitabine or gemcitabine-based chemotherapy. All current chemotherapies for pancreatic cancer are associated with dose-limiting hematologic toxicity and other adverse effects that require ongoing monitoring and dosage adjustment to balance the benefits and risks of treatment. Pharmacists can play an important role in monitoring and providing drug information and guidance to patients and oncologists. Current investigational strategies include efforts to improve chemotherapy response rates and outcomes through modulation of cell signaling pathways and use of nanotechnology to improve drug delivery.
  
  
  CONCLUSIONS
  Current management of pancreatic cancer is multifaceted, involving anticancer therapy, supportive care, and toxicity management. Standard systemic therapy with gemcitabine as a single agent or in combination with other cytotoxic agents provides modest benefits in terms of response and symptom control.
authors.affiliation: Arizona Cancer Center, 1891 West Orange Grove, Tucson, AZ 85704, USA. chriscampen@gmail.com
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Campen
authors.forename: Tomislav
authors.initials: T
authors.lastname: Dragovich
authors.forename: Amanda F
authors.initials: AF
authors.lastname: Baker
mesh_terms: D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D019468:Disease Management; D006801:Humans; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery*