title: Pancreatic cancer: from state-of-the-art treatments to promising novel therapies.
abstract: Pancreatic cancer is expected to be the second deadliest malignancy in the USA by 2020. The survival rates for patients with other gastrointestinal malignancies have increased consistently during the past 30 years; unfortunately, however, the outcomes of patients with pancreatic cancer have not changed significantly. Although surgery remains the only curative treatment for pancreatic cancer, therapeutic strategies based on initial resection have not substantially improved the survival of patients with resectable disease over the past 25 years; presently, more than 80% of patients suffer disease relapse after resection. Preclinical evidence that pancreatic cancer is a systemic disease suggests a possible benefit for early administration of systemic therapy in these patients. In locally advanced disease, the role of chemoradiotherapy is increasingly being questioned, particularly considering the results of the LAP-07 trial. Novel biomarkers are clearly needed to identify subsets of patients likely to benefit from chemoradiotherapy. In the metastatic setting, FOLFIRINOX (folinic acid, 5-fluorouracil, irinotecan, and oxaliplatin), and nab-paclitaxel plus gemcitabine have yielded only modest improvements in survival. Thus, new treatments are urgently needed for patients with pancreatic cancer. Herein, we review the state-of-the-art of pancreatic cancer treatment, and the upcoming novel therapeutics that hold promise in this disease are also discussed.
authors.affiliation: Department of Internal Medicine, Division of Oncology, and Center for Investigational Therapeutics, Huntsman Cancer Institute, University of Utah School of Medicine, University of Utah, Suite 2100, 2000 Circle of Hope, Salt Lake City, UT 84112, USA.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Garrido-Laguna
authors.affiliation: Gastrointestinal Cancer Clinical Research Unit, Clinical Research Program, Spanish National Cancer Research Centre (CNIO), Calle de Melchor Fernández Almagro 3, 28029 Madrid, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Hidalgo
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D019496:Cancer Vaccines / Q000627:therapeutic use; D021441:Carcinoma, Pancreatic Ductal / Q000628:therapy*; D002986:Clinical Trials as Topic; D003603:Cytotoxins / Q000627:therapeutic use; D053823:Hedgehog Proteins / Q000037:antagonists & inhibitors; D006801:Humans; D006821:Hyaluronoglucosaminidase / Q000494:pharmacology; D007167:Immunotherapy / Q000379:methods; D050503:Indoleamine-Pyrrole 2,3,-Dioxygenase / Q000037:antagonists & inhibitors; D053612:Janus Kinases / Q000037:antagonists & inhibitors; D058990:Molecular Targeted Therapy / Q000379:methods* / Q000639:trends; D020360:Neoadjuvant Therapy / Q000379:methods; D009362:Neoplasm Metastasis; D014411:Neoplastic Stem Cells / Q000187:drug effects; D010190:Pancreatic Neoplasms / Q000628:therapy*; D000081082:Phosphoinositide-3 Kinase Inhibitors; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors; D016896:Treatment Outcome; D018631:ras Proteins / Q000037:antagonists & inhibitors
chemical_list: D000911:Antibodies, Monoclonal; D019496:Cancer Vaccines; D003603:Cytotoxins; D053823:Hedgehog Proteins; C576710:IDO1 protein, human; D050503:Indoleamine-Pyrrole 2,3,-Dioxygenase; D000081082:Phosphoinositide-3 Kinase Inhibitors; D011993:Recombinant Fusion Proteins; C546842:MTOR protein, human; D053612:Janus Kinases; D058570:TOR Serine-Threonine Kinases; D006821:Hyaluronoglucosaminidase; D018631:ras Proteins
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