Open AccessAdvanced Pancreatic Cancer: Flourishing Novel Approaches in the Era of Biological Therapy
Author(s) -
Chiu Joanne W.,
Wong Hilda,
Leung Roland,
Pang Roberta,
Cheung TanTo,
Fan SheungTat,
Poon Ronnie,
Yau Thomas
Publication year - 2014
Publication title -
the oncologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.176
H-Index - 164
eISSN - 1549-490X
pISSN - 1083-7159
DOI - 10.1634/theoncologist.2012-0131
Subject(s) - medicine , erlotinib , targeted therapy , pancreatic cancer , gemcitabine , epidermal growth factor receptor , cancer research , personalized medicine , pi3k/akt/mtor pathway , cancer , immunotherapy , oncology , bioinformatics , signal transduction , biology , biochemistry
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.