title: New Advances in the Treatment of Metastatic Pancreatic Cancer.
abstract: BACKGROUND
  Pancreatic ductal adenocarcinoma (PDAC) is characterised by an extremely poor overall survival (OS) compared to other solid tumours. As the incidence of the disease is rising and the treatment options are limited, PDAC is projected to be the 2nd leading cause of cancer-related deaths in the United States by 2030. A majority of patients are not eligible for curative resection at the time of diagnosis, and those that are resected will often relapse within the first few years after surgery.
  
  
  CONCLUSIONS
  Until recently, the nucleoside analogue gemcitabine has been the standard of care for patients with non-resectable PDAC with only marginal effects on OS. In 2011, the gemcitabine-free FOLFIRINOX regimen (folinic acid, fluorouracil, irinotecan and oxaliplatin) showed a significant survival advantage for patients with metastatic PDAC in a phase III trial. In 2013, the Metastatic Pancreatic Adenocarcinoma Trial phase III trial with nano- formulated albumin-bound paclitaxel (nab-paclitaxel) in combination with gemcitabine also resulted in a significant survival extension compared to gemcitabine monotherapy. However, both intensified therapy regimens show a broad spectrum of side effects and patients need to be carefully selected for the most appropriate protocol.
  
  
  CONCLUSIONS
  In this study, recent advances in the chemotherapeutic options available to treat metastatic PDAC and their implications for today’s treatment choices are reviewed.
authors.forename: Marvin
authors.initials: M
authors.lastname: Schober
authors.forename: Muhammad A
authors.initials: MA
authors.lastname: Javed
authors.forename: G
authors.initials: G
authors.lastname: Beyer
authors.forename: Nha
authors.initials: N
authors.lastname: Le
authors.forename: Alessio
authors.initials: A
authors.lastname: Vinci
authors.forename: Malin
authors.initials: M
authors.lastname: Sund
authors.forename: Albrecht
authors.initials: A
authors.lastname: Neesse
authors.forename: Sebastian
authors.initials: S
authors.lastname: Krug
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D021441:Carcinoma, Pancreatic Ductal / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary*; D006801:Humans; D010190:Pancreatic Neoplasms / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents