Pancreatic adenocarcinoma: Beyond first line, where are we?

Pancreatic cancer is considered one of the most aggressive cancers, with an increasing incidence in recent years. To date, chemotherapy is still the standard of care for advanced metastatic disease, unfortunately providing only a slight advantage in terms of survival. The molecular and cellular char...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2021-05, Vol.27 (17), p.1847-1863
Main Authors: Cherri, Sara, Noventa, Silvia, Zaniboni, Alberto
Format: Article
Language:English
Subjects:
Adenocarcinoma - drug therapy
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Evidence Review
Humans
Pancreatic Neoplasms - drug therapy
Tumor Microenvironment
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Summary:Pancreatic cancer is considered one of the most aggressive cancers, with an increasing incidence in recent years. To date, chemotherapy is still the standard of care for advanced metastatic disease, unfortunately providing only a slight advantage in terms of survival. The molecular and cellular characteristics of pancreatic cancer cells, as well as the cells that characterize the pancreatic tumour microenvironment, are the basis of the mechanisms of resistance to treatment. After progression during first-line treatment, few patients are eligible for second-line treatment due to the loss of performance status. To date, a clear survival advantage has not yet been demonstrated for second-line chemotherapy. Precision medicine could be the key to increasing responses to cancer treatment and finally impacting survival in this difficult-to-treat disease. In this review, we analyze current recommendations in the second-line setting and potential future prospects.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v27.i17.1847