FOLFIRINOX and translational studies: Towards personalized therapy in pancreatic cancer

作     者：Chiara Caparello Laura L Meijer Ingrid Garajova Alfredo Falcone Tessa Y Le Large Niccola Funel Geert Kazemier Godefridus J Peters Enrico Vasile Elisa Giovannetti 

作者机构：University Hospital of Pisa 56124 Pisa Italy Department of Medical Oncology VU University Medical Center 1081 HV Amsterdam The Netherlands Department of Surgery VU University Medical Center 1081 HV Amsterdam The Netherlands Department of Experimental Diagnostic and Speciality Medicine University of Bologna Sant'Orsola-Malpighi Hospital Via Massarenti 9 40138 Bologna Italy Cancer Pharmacology Lab AIRC Start-Up Unit University of Pisa 56124 Pisa Italy CNR-Nano Institute of Nanoscience and Nanotechnology University of Pisa 56124 Pisa Italy 

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

年 卷 期：2016年第22卷第31期

页      面：6987-7005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] 

基　　金：Supported by AIRC/Start-Up(to Giovannetti E) Istituto Toscano Tumori ITT-2011(to Caparello C,Funel N,Vasile E and Giovannetti E) Regione Toscana“Fas Salute”(to Funel N and Giovannetti E) Bennink Foundation(to Meijer LL,Le Large TY,Giovannetti E and Kazemier G) CCA Foundation(to Giovannetti E) 

主　　题：FOLFIRINOX Personalized therapy New treatments MicroR NA Pancreatic cancer 

摘      要：Pancreatic cancer is an extremely aggressive disease; although progress has been made in the last few years, the prognosis of these patients remains dismal. FOLFIRINOX is now considered a standard treatment in first-line setting, since it demonstrated an improved overall and progression-free survival vs gemcitabine alone. However, the enthusiasm over the benefit of this three-drug regimen is tempered by the associated increased toxicity profile, and many efforts have been made to improve the feasibility of this schedule. After a more recent phase Ⅲ trial showing an improved outcome over gemcitabine, the combination of gemcitabine/nab-paclitaxel emerged as another standard first-line treatment. However, this treatment is also associated with more side effects. In addition, despite initial promising data on the predictive role of SPARClevels, recent studies showed that these levels are not associated with nab-paclitaxel efficacy. The choice to use this treatment over FOLFIRINOX is therefore a topic of debate, also because no validated biomarkers to guide FOLFIRINOX treatment are available. In the era of actionable mutations and target agents it would be desirable to identify molecular factors or biomarkers to predict response to therapy in order to maximize the efficacy of treatment and avoid useless toxic effects for non-responding patients. However, until today the milestone of treatment for pancreatic cancer remains chemotherapy combinations, without predictive or monitoring tools existing to optimize therapy. This review analyzes the state-of-the-art treatments, promises and limitations of targeted therapies, ongoing trials and future perspectives, including potential role of microR NAs as predictive biomarkers.