title: Safety of palliative chemotherapy in advanced pancreatic cancer.
abstract: BACKGROUND
  Pancreatic cancer is a major health burden. Currently, the majority of patients is diagnosed at advanced stages and thus qualifies for palliative chemotherapy. Gemcitabine monotherapy has been the gold standard for many years. Recently, more effective chemotherapeutic regimens have shown meaningful clinical activity in patients with metastatic pancreatic cancer.
  
  
  METHODS
  In this review we have aimed to give an overview on the treatment options for patients diagnosed with metastatic pancreatic cancer with an emphasis on the safety and toxicity of the applied regimens. We have conducted a pubmed search using the terms 'metastatic pancreatic cancer', 'palliative chemotherapy', 'safety' and 'toxicity'. Our special focus rested on randomized phase III trials to provide readers with the highest level of available evidence.
  
  
  CONCLUSIONS
  The emergence of new and more effective chemotherapy regimens gives clinicians more freedom in the treatment of metastatic pancreatic cancer. While being more effective, these regiments have a considerable degree of toxicity. Choosing the right treatment for any individual will be the next major challenge treating patients with pancreatic cancer.
authors.affiliation: a Department of Internal Medicine III and Comprehensive Cancer Center , Klinikum Grosshadern, Ludwig-Maximilians-University of Munich , Munich , Germany.
authors.forename: C Benedikt
authors.initials: CB
authors.lastname: Westphalen
authors.affiliation: a Department of Internal Medicine III and Comprehensive Cancer Center , Klinikum Grosshadern, Ludwig-Maximilians-University of Munich , Munich , Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Kruger
authors.affiliation: a Department of Internal Medicine III and Comprehensive Cancer Center , Klinikum Grosshadern, Ludwig-Maximilians-University of Munich , Munich , Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Haas
authors.affiliation: a Department of Internal Medicine III and Comprehensive Cancer Center , Klinikum Grosshadern, Ludwig-Maximilians-University of Munich , Munich , Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Heinemann
authors.affiliation: a Department of Internal Medicine III and Comprehensive Cancer Center , Klinikum Grosshadern, Ludwig-Maximilians-University of Munich , Munich , Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Boeck
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D016032:Randomized Controlled Trials as Topic; D000093542:Gemcitabine
chemical_list: D000970:Antineoplastic Agents; D003841:Deoxycytidine; D000093542:Gemcitabine
keywords: FOLFIRINOX; Gemcitabine; nab-paclitaxel; palliative chemotherapy; pancreatic cancer; safety