Advanced pancreatic cancer: flourishing novel approaches in the era of biological therapy.
The progress in the development of systemic treatment for advanced pancreatic cancer (APC) has been slow. The mainstream treatment remains using chemotherapy including gemcitabine, FOLFIRINOX, and nab-paclitaxel. Erlotinib is the only approved biological therapy with marginal benefit. Studies of agents targeting epidermal growth factor receptor, angiogenesis, and RAS signaling have not been satisfying, and the usefulness of targeted therapy in APC is uncertain. Understanding in molecular processes and tumor biology has opened the door for new treatment strategies such as targeting insulin-like growth factor 1 receptor, transforming growth factor β, phosphoinositide 3-kinase/AKT/mammalian target of rapamycin pathway, and Notch pathway. New directions also include the upcoming immunotherapy and many novel agents that act on the microenvironment. The practice of personalized medicine using predictive biomarkers and pharmacogenomics signatures may also enhance the effectiveness of existing treatment. Future treatment approaches may involve comprehensive genomic assessment of tumor and integrated combinations of multiple agents to overcome treatment resistance.
['Chiu|Joanne W|JW|', 'Wong|Hilda|H|', 'Leung|Roland|R|', 'Pang|Roberta|R|', 'Cheung|Tan-To|TT|', 'Fan|Sheung-Tat|ST|', 'Poon|Ronnie|R|', 'Yau|Thomas|T|']
D014408:Biomarkers, Tumor D003841:Deoxycytidine D066246:ErbB Receptors D000069347:Erlotinib Hydrochloride D006801:Humans D058990:Molecular Targeted Therapy D009367:Neoplasm Staging D010190:Pancreatic Neoplasms D057285:Precision Medicine D047428:Protein Kinase Inhibitors D011799:Quinazolines D015398:Signal Transduction
Advanced pancreatic cancer Biological therapy Gemcitabine Targeted therapy