title: Promising new therapies in advanced pancreatic adenocarcinomas.
abstract: Pancreatic ductal adenocarcinoma is a lethal disease due to late diagnosis, early metastasis and the lack of effective therapies. In patients with metastatic disease, 1-year survival ranges from 17 to 23% and 5-year survival is less than 5%. This necessitates an urgent need for developing more effective therapies. Targeting the neoplastic cells has been largely ineffective due to the dense stroma, which is a physical barrier for effective drug delivery and also a source for different factors that promote tumor progression and immunosuppression. In this review, we focus on understanding the complex biology of this tumor as it relates to the evaluation of previously failed molecularly targeted trials and review potential new therapies that are emerging in the treatment of metastatic pancreatic ductal adenocarcinoma.
authors.affiliation: Department of Medical Oncology, Cancer Treatment Centers of America at Western Regional Medical Center, 14200 W. Fillmore St., Goodyear, AZ 85338, USA.
authors.forename: Madappa
authors.initials: M
authors.lastname: Kundranda
authors.forename: Toufic
authors.initials: T
authors.lastname: Kachaamy
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000453:epidemiology / Q000235:genetics; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D016503:Drug Delivery Systems; D006801:Humans; D058990:Molecular Targeted Therapy; D009362:Neoplasm Metastasis; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000235:genetics; D015398:Signal Transduction / Q000187:drug effects; D016019:Survival Analysis
keywords: EGFR; JAK-STAT; autophagy; oncolytic virus; pancreatic ductal adenocarcinoma; sonic hedgehog; stroma; tumor microenvironment