title: Optimum chemotherapy in the management of metastatic pancreatic cancer.
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.
authors.affiliation: Marwan Ghosn, Hampig Raphael Kourie, Fadi El Karak, Colette Hanna, Joelle Antoun, Dolly Nasr, Department of Oncology, Faculty of Medicine, Saint Joseph University, Beirut 166830, Lebanon.
authors.forename: Marwan
authors.initials: M
authors.lastname: Ghosn
authors.affiliation: Marwan Ghosn, Hampig Raphael Kourie, Fadi El Karak, Colette Hanna, Joelle Antoun, Dolly Nasr, Department of Oncology, Faculty of Medicine, Saint Joseph University, Beirut 166830, Lebanon.
authors.forename: Hampig Raphael
authors.initials: HR
authors.lastname: Kourie
authors.affiliation: Marwan Ghosn, Hampig Raphael Kourie, Fadi El Karak, Colette Hanna, Joelle Antoun, Dolly Nasr, Department of Oncology, Faculty of Medicine, Saint Joseph University, Beirut 166830, Lebanon.
authors.forename: Fadi
authors.initials: F
authors.lastname: El Karak
authors.affiliation: Marwan Ghosn, Hampig Raphael Kourie, Fadi El Karak, Colette Hanna, Joelle Antoun, Dolly Nasr, Department of Oncology, Faculty of Medicine, Saint Joseph University, Beirut 166830, Lebanon.
authors.forename: Colette
authors.initials: C
authors.lastname: Hanna
authors.affiliation: Marwan Ghosn, Hampig Raphael Kourie, Fadi El Karak, Colette Hanna, Joelle Antoun, Dolly Nasr, Department of Oncology, Faculty of Medicine, Saint Joseph University, Beirut 166830, Lebanon.
authors.forename: Joelle
authors.initials: J
authors.lastname: Antoun
authors.affiliation: Marwan Ghosn, Hampig Raphael Kourie, Fadi El Karak, Colette Hanna, Joelle Antoun, Dolly Nasr, Department of Oncology, Faculty of Medicine, Saint Joseph University, Beirut 166830, Lebanon.
authors.forename: Dolly
authors.initials: D
authors.lastname: Nasr
mesh_terms: D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015195:Drug Design; D006801:Humans; D058990:Molecular Targeted Therapy; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000401:mortality / Q000556:secondary*; D015398:Signal Transduction / Q000187:drug effects; D016896:Treatment Outcome
keywords: Chemotherapy; Evolution; Metastatic pancreatic cancer; Recent therapies; Targeted therapy