Systemic treatment of pancreatic cancer revisited

Michel Ducreux, Thomas Seufferlein, Jean Luc Van Laethem, Pierre Laurent-Puig, Cristina Smolenschi, David Malka, Valérie Boige, Antoine Hollebecque, Thierry Conroy

Research output: Contribution to journalReview articlepeer-review

75 Scopus citations

Abstract

Pancreatic cancer is considered to be one of the most aggressive cancers. For unknown reasons, the incidence of pancreatic cancer is slowly rising and so too are mortality rates. Over 75% of patients are diagnosed with locally advanced disease or with metastases; and more than 95% of patients have metastases at diagnosis or will develop metastases during their follow-up. Despite recent improvements in the therapy of pancreatic cancer, initially with demonstration of the activity of the FOLFIRINOX regimen and subsequently the approval of nab-paclitaxel in combination with gemcitabine, prognosis remains poor and the 5-year survival rate is less than 5%. To date, neither personalized medicine nor immunotherapy, the 2 recent revolutions of cancer treatment, have delivered major positive results in the treatment of pancreatic cancer; and it is especially clear that immune checkpoint inhibitors will not become a major tool in the treatment of pancreatic cancer. There are many ongoing studies, including those exploring combinations of chemotherapy with immunotherapy. Vaccines or T cells modified with a chimeric antigen receptor (CAR-T cells) could also play a role in the treatment of cancer in the future. The aim of this review is to discuss recent improvements in standard of care, major obstacles to overcome, recent results of new treatment combinations, and the most interesting innovative approaches.

Original languageEnglish
Pages (from-to)28-38
Number of pages11
JournalSeminars in Oncology
Volume46
Issue number1
DOIs
StatePublished - Feb 2019
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2019 The Authors

Keywords

  • Drug therapy
  • Immunotherapy
  • Pancreatic cancer
  • Personalized medicine
  • Precision medicine

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