New directions in the management of advanced pancreatic cancer: A review

Caio M. Rocha-Lima

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Complete surgical resection is the only potentially curative option for pancreatic cancer. However, most patients have advanced/metastatic disease at the time of diagnosis, or will relapse after surgery. Systemic chemotherapy is only palliative. Gemcitabine-based therapy is an acceptable standard for unresectable locally advanced/metastatic pancreatic cancer, but average median survival is only 6 months. The addition of other chemotherapies (including other antimetabolites, platinum, and topoisomerase I inhibitors) or targeted therapies (farnesyl transferase inhibitors, metalloproteinase inhibitors, cetuximab and bevacizumab) to gemcitabine has failed to improve outcome. The combination of gemcitabine and erlotinib, a small-molecule tyrosine kinase inhibitor of the human epidermal growth factor receptor, was recently approved by the US/European authorities for use in advanced disease. In a phase III trial, the combination demonstrated a significant improvement in overall survival compared with gemcitabine monotherapy. Positive efficacy results have also been observed in a phase III trial, favoring the addition of capecitabine to gemcitabine compared with gemcitabine alone. This review focuses on the recent developments in systemic treatment, and discusses how novel agents might be incorporated into future treatment strategies for pancreatic cancer.

Original languageEnglish
Pages (from-to)435-446
Number of pages12
JournalAnti-Cancer Drugs
Volume19
Issue number5
DOIs
StatePublished - Jun 1 2008

Fingerprint

gemcitabine
Pancreatic Neoplasms
Topoisomerase I Inhibitors
Antimetabolites
Drug Therapy
Survival
Metalloproteases
Therapeutics
Transferases
Platinum
Epidermal Growth Factor Receptor
Protein-Tyrosine Kinases
Direction compound
Recurrence

Keywords

  • Bevacizumab
  • Capecitabine
  • Cetuximab
  • Epidermal growth factor receptor
  • Erlotinib
  • Gemcitabine
  • Pancreatic cancer
  • Vascular endothelial growth factor

ASJC Scopus subject areas

  • Pharmacology
  • Cancer Research
  • Oncology

Cite this

New directions in the management of advanced pancreatic cancer : A review. / Rocha-Lima, Caio M.

In: Anti-Cancer Drugs, Vol. 19, No. 5, 01.06.2008, p. 435-446.

Research output: Contribution to journalArticle

Rocha-Lima, Caio M. / New directions in the management of advanced pancreatic cancer : A review. In: Anti-Cancer Drugs. 2008 ; Vol. 19, No. 5. pp. 435-446.
@article{0fd7c01d65e346c4937c1f990c0b6acc,
title = "New directions in the management of advanced pancreatic cancer: A review",
abstract = "Complete surgical resection is the only potentially curative option for pancreatic cancer. However, most patients have advanced/metastatic disease at the time of diagnosis, or will relapse after surgery. Systemic chemotherapy is only palliative. Gemcitabine-based therapy is an acceptable standard for unresectable locally advanced/metastatic pancreatic cancer, but average median survival is only 6 months. The addition of other chemotherapies (including other antimetabolites, platinum, and topoisomerase I inhibitors) or targeted therapies (farnesyl transferase inhibitors, metalloproteinase inhibitors, cetuximab and bevacizumab) to gemcitabine has failed to improve outcome. The combination of gemcitabine and erlotinib, a small-molecule tyrosine kinase inhibitor of the human epidermal growth factor receptor, was recently approved by the US/European authorities for use in advanced disease. In a phase III trial, the combination demonstrated a significant improvement in overall survival compared with gemcitabine monotherapy. Positive efficacy results have also been observed in a phase III trial, favoring the addition of capecitabine to gemcitabine compared with gemcitabine alone. This review focuses on the recent developments in systemic treatment, and discusses how novel agents might be incorporated into future treatment strategies for pancreatic cancer.",
keywords = "Bevacizumab, Capecitabine, Cetuximab, Epidermal growth factor receptor, Erlotinib, Gemcitabine, Pancreatic cancer, Vascular endothelial growth factor",
author = "Rocha-Lima, {Caio M.}",
year = "2008",
month = "6",
day = "1",
doi = "10.1097/CAD.0b013e3282fc9d11",
language = "English",
volume = "19",
pages = "435--446",
journal = "Anti-Cancer Drugs",
issn = "0959-4973",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - New directions in the management of advanced pancreatic cancer

T2 - A review

AU - Rocha-Lima, Caio M.

PY - 2008/6/1

Y1 - 2008/6/1

N2 - Complete surgical resection is the only potentially curative option for pancreatic cancer. However, most patients have advanced/metastatic disease at the time of diagnosis, or will relapse after surgery. Systemic chemotherapy is only palliative. Gemcitabine-based therapy is an acceptable standard for unresectable locally advanced/metastatic pancreatic cancer, but average median survival is only 6 months. The addition of other chemotherapies (including other antimetabolites, platinum, and topoisomerase I inhibitors) or targeted therapies (farnesyl transferase inhibitors, metalloproteinase inhibitors, cetuximab and bevacizumab) to gemcitabine has failed to improve outcome. The combination of gemcitabine and erlotinib, a small-molecule tyrosine kinase inhibitor of the human epidermal growth factor receptor, was recently approved by the US/European authorities for use in advanced disease. In a phase III trial, the combination demonstrated a significant improvement in overall survival compared with gemcitabine monotherapy. Positive efficacy results have also been observed in a phase III trial, favoring the addition of capecitabine to gemcitabine compared with gemcitabine alone. This review focuses on the recent developments in systemic treatment, and discusses how novel agents might be incorporated into future treatment strategies for pancreatic cancer.

AB - Complete surgical resection is the only potentially curative option for pancreatic cancer. However, most patients have advanced/metastatic disease at the time of diagnosis, or will relapse after surgery. Systemic chemotherapy is only palliative. Gemcitabine-based therapy is an acceptable standard for unresectable locally advanced/metastatic pancreatic cancer, but average median survival is only 6 months. The addition of other chemotherapies (including other antimetabolites, platinum, and topoisomerase I inhibitors) or targeted therapies (farnesyl transferase inhibitors, metalloproteinase inhibitors, cetuximab and bevacizumab) to gemcitabine has failed to improve outcome. The combination of gemcitabine and erlotinib, a small-molecule tyrosine kinase inhibitor of the human epidermal growth factor receptor, was recently approved by the US/European authorities for use in advanced disease. In a phase III trial, the combination demonstrated a significant improvement in overall survival compared with gemcitabine monotherapy. Positive efficacy results have also been observed in a phase III trial, favoring the addition of capecitabine to gemcitabine compared with gemcitabine alone. This review focuses on the recent developments in systemic treatment, and discusses how novel agents might be incorporated into future treatment strategies for pancreatic cancer.

KW - Bevacizumab

KW - Capecitabine

KW - Cetuximab

KW - Epidermal growth factor receptor

KW - Erlotinib

KW - Gemcitabine

KW - Pancreatic cancer

KW - Vascular endothelial growth factor

UR - http://www.scopus.com/inward/record.url?scp=42349085265&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=42349085265&partnerID=8YFLogxK

U2 - 10.1097/CAD.0b013e3282fc9d11

DO - 10.1097/CAD.0b013e3282fc9d11

M3 - Article

C2 - 18418211

AN - SCOPUS:42349085265

VL - 19

SP - 435

EP - 446

JO - Anti-Cancer Drugs

JF - Anti-Cancer Drugs

SN - 0959-4973

IS - 5

ER -