Metastatic pancreatic cancer: Is there a light at the end of the tunnel?

作     者：Vanja Vaccaro Isabella Sperduti Sabrina Vari Emilio Bria Davide Melisi Carlo Garufi Carmen Nuzzo Aldo Scarpa Giampaolo Tortora Francesco Cognetti Michele Reni Michele Milella 

作者机构：Medical Oncology ARegina Elena National Cancer Institute Medical Oncology A and BiostatisticsRegina Elena National Cancer Institute Medical OncologyUniversity of VeronaAzienda Ospedaliera Universitaria Integrata ARC-Net Research Centre and Department of PathologyDiagnostics and SurgeryUniversity of Verona Medical Oncology UnitDepartment of OncologySan Raffaele Scientific Institute 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2015年第21卷第16期

页      面：4788-4801页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Pancreatic cancer Metastatic disease Chemotherapy Folfirinox nab -Paclitaxel 

摘      要：Due to extremely poor prognosis,pancreatic cancer(PDAC)represents the fourth leading cause of cancerrelated death in Western *** more than a decade,gemcitabine(Gem)has been the mainstay of first-line PDAC *** efforts aimed at improving single-agent Gem efficacy by either combining it with a second cytotoxic/molecularly targeted agent or pharmacokinetic modulation provided disappointing ***,the field of systemic therapy of advanced PDAC is finally moving *** has shown promise over single-agent Gem:regimens like PEFG-PEXG-PDXG and GTX provide significant potential advantages in terms of survival and/or disease control,although sometimes at the cost of poor *** PRODIGE 4/ACCORD 11 was the first phaseⅢtrial to provide unequivocal benefit using the polychemotherapy regimen FOLFIRINOX;however the less favorable safety profile and the characteristics of the enrolled population,restrict the use of FOLFIRINOX to young and fit PDAC *** nanoparticle albumin-bound paclitaxel(nab-Paclitaxel)formulation was developed to overcome resistance due to the desmoplastic stroma surrounding pancreatic cancer *** of whether or not this is its main mechanisms of action,the combination of nabPaclitaxel plus Gem showed a statistically and clinically significant survival advantage over single agent Gem and significantly improved all the secondary ***,recent findings on maintenance therapy are opening up potential new avenues in the treatment of advanced PDAC,particularly in a new era in which highly effective first-line regimens allow patients to experience prolonged disease ***,we provide an overview of recent advances in the systemic treatment of advanced PDAC,mostly focusing on recent findings that have set new standards in metastatic *** avenues for further development in the metastatic setting and current efforts to integratenew effective chemotherapy regimens