RT Journal Article
SR Electronic
T1 Present Treatment and Future Expectations in Advanced Pancreatic Cancer
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 1303
OP 1308
VO 28
IS 2B
A1 GEORGE P. STATHOPOULOS
A1 NIKOS ANDROULAKIS
A1 JOHN SOUGLAKOS
A1 JOHN STATHOPOULOS
A1 VASSILIS GEORGOULIAS
YR 2008
UL http://ar.iiarjournals.org/content/28/2B/1303.abstract
AB Advanced or metastatic pancreatic cancer is an incurable disease. The main treatment is chemotherapy with cytotoxic agents. On the basis of our experience in clinical trials, the objectives have been to determine response rate, life prolongation and clinical benefit. In our trials and in those of other authors, all of these objectives have been met. Responses remain low; 5-25% of patients have a partial response, life prolongation is significantly achieved versus best supportive care, and clinical benefit is observed in 40-60% of patients. Rarely do patients survive for over 2 years and no patient is cured. The standard cytotoxic treatment is the agent gemcitabine. The addition of other agents, such as cisplatin, irinotecan, oxaliplatin and taxanes, in combination with gemcitabine, has shown higher response rates but overall survival has not significantly increased. Research related to monoclonal or gene therapies for pancreatic cancer has created hope. The horizon has been broadened by a recent report on a tyrosine kinase inhibitor, erlotinib (EGFR inhibitor) which has shown significantly longer median survival, when combined with gemcitabine versus gemcitabine alone. Other anti-angiogenic agents, such as cetuximab and the anti-Her-2, herceptin, are now being tested in ongoing trials. Farnesyl transferase inhibitors represent another direction which research is taking; this is related to the Ras-oncogenes (K-, H- and N-ras) which are known to be involved in signal transduction pathways regulating cell growth and differentiation in many human cancers including pancreatic. Trials of these and other targeting therapies have not produced the expected effectiveness. The combination of monoclonal and/or gene therapies with cytotoxic agents suggests there is hope for the future. Copyright© 2008 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved