title: Current and Emerging Therapies in Metastatic Pancreatic Cancer.
abstract: Targeted therapies and immunotherapy have changed the face of multiple solid malignancies, including metastatic melanoma and lung cancer, but no such therapies exist for pancreatic ductal adenocarcinoma (PDAC) despite the knowledge of key mutations and an increasing understanding of the tumor microenvironment. Until now, most clinical studies have not been biomarker driven in this highly immunosuppressive and heterogeneous cancer. Ongoing basic and translational studies are better classifying the disease in hopes of identifying critical pathways that distinguish the unique PDAC subtypes, which will lead to personalized therapies. In this review, we discuss the current treatment options for metastatic pancreatic cancer and highlight current ongoing clinical trials, which aim to target the stroma and the immune microenvironment either alone or in combination with standard chemotherapy. Identifying biomarkers and key resistance pathways and targeting these pathways in a personalized manner in combination with chemotherapy are likely to yield a more immediate and durable clinical benefit.Clin Cancer Res; 23(7); 1670-8. ©2017 AACRSee all articles in thisCCR Focussection, "Pancreatic Cancer: Challenge and Inspiration."
authors.affiliation: Division of Medical Oncology, Columbia University Medical Center, and New York Presbyterian Hospital, Herbert Irving Pavilion, New York, New York. gam2140@cumc.columbia.edu.
authors.forename: Gulam Abbas
authors.initials: GA
authors.lastname: Manji
authors.affiliation: Department of Pathology and Cell Biology, Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York.
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: Olive
authors.affiliation: Division of Medical Oncology, Columbia University Medical Center, and New York Presbyterian Hospital, Herbert Irving Pavilion, New York, New York.
authors.forename: Yvonne M
authors.initials: YM
authors.lastname: Saenger
authors.affiliation: Division of Medical Oncology, Columbia University Medical Center, and New York Presbyterian Hospital, Herbert Irving Pavilion, New York, New York.
authors.forename: Paul
authors.initials: P
authors.lastname: Oberstein
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D021441:Carcinoma, Pancreatic Ductal / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D002986:Clinical Trials as Topic; D006801:Humans; D007167:Immunotherapy; D009362:Neoplasm Metastasis; D016609:Neoplasms, Second Primary / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D057285:Precision Medicine; D059016:Tumor Microenvironment / Q000235:genetics