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Pharmacotherapeutic strategies for treating pancreatic cancer: advances and challenges
- Source :
- Expert Opinion on Pharmacotherapy. 20:535-546
- Publication Year :
- 2018
- Publisher :
- Informa UK Limited, 2018.
-
Abstract
- Despite many efforts to improve the outcome of pancreatic ductal adenocarcinoma (PDAC), its prognosis remains poor, which is mostly related to late diagnosis and drug resistance. Improving systemic therapy is considered the major challenge in improving the outcome of this disease.This review covers novel chemotherapy and targeted agents in the treatment of PDAC, with a focus on advanced stage disease.Current frontline therapies used in the treatment of patients with PDAC with favorable performance status are gemcitabine (GEM) and nab-paclitaxel or 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX). PDAC has a number of genetic mutations that may explain its biological behavior, such as KRAS, p53 and CDK2NA, which occur in more than 90% of cases. Unfortunately, to this day, a specific targeting agent to any of those frequent gene mutations is lacking. Emerging areas of targeted therapies include the DNA repair, stroma, metabolism, and stem cells. Immunotherapy with either vaccines or immune checkpoint inhibitors has not produced any significant improvements in outcome of PDAC. Incorporating different approaches in therapy, including conventional, immunological, and others, is key in offering patients with the best possible care.
- Subjects :
- Oncology
medicine.medical_specialty
Pancreatic ductal adenocarcinoma
endocrine system diseases
medicine.medical_treatment
Drug resistance
Adenocarcinoma
03 medical and health sciences
0302 clinical medicine
Stroma
Internal medicine
Pancreatic cancer
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Pharmacology (medical)
Pharmacology
Chemotherapy
business.industry
General Medicine
Immunotherapy
Prognosis
medicine.disease
digestive system diseases
Pancreatic Neoplasms
Late diagnosis
030220 oncology & carcinogenesis
business
030217 neurology & neurosurgery
Carcinoma, Pancreatic Ductal
Subjects
Details
- ISSN :
- 17447666 and 14656566
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- Expert Opinion on Pharmacotherapy
- Accession number :
- edsair.doi.dedup.....f419bdc29b43ce9e1ce71cfc206e9a36