Mahalingam Devalingam, Kelly Kevin R, Swords Ronan T, Carew Jennifer, Nawrocki Steffan T, Giles Francis J
Institute of Drug Development, Division of Cancer Research and Therapy Center, University of Texas Health Science Center, San Antonio, Texas 78229, USA.
Expert Opin Emerg Drugs. 2009 Jun;14(2):311-28. doi: 10.1517/14728210902972502.
Pancreatic cancer is the fourth leading cause of cancer-related death in the US. However, there is a growing belief that novel biological agents could improve survival of patients with this cancer. Gemcitabine-based chemotherapy remains the cornerstone treatment for advanced pancreatic cancers. So far, the current targeted agents that have been used in combination with gemcitabine have failed to improve clinical outcomes. This failure may stem from the heterogeneous molecular pathogenesis of pancreatic cancers, which involves several oncogenic pathways and defined genetic mutations.
The aims of this review are: i) to define the existing treatments available at present for patients with pancreatic cancers in the neo-adjuvant, adjuvant, locally advanced and metastatic settings; ii) to highlight the molecular heterogeneity of the cancers and the rationale for targeting specific oncogenic pathways; iii) to give an overview of targeted agents that may potentially have an impact in the treatment of pancreatic cancers.
Molecular pathogenesis of pancreatic cancer involves several pathways and defined genetic mutations. Targeting these complex molecular pathways with a combination of novel biological and chemotherapeutic agents could potentially improve patient outcome.
胰腺癌是美国癌症相关死亡的第四大主要原因。然而，越来越多的人认为新型生物制剂可以提高这种癌症患者的生存率。以吉西他滨为基础的化疗仍然是晚期胰腺癌的基石治疗方法。到目前为止，目前与吉西他滨联合使用的靶向药物未能改善临床结果。这种失败可能源于胰腺癌异质性的分子发病机制，其中涉及多种致癌途径和特定的基因突变。
本综述的目的是：i）确定目前在新辅助、辅助、局部晚期和转移性胰腺癌患者中可用的现有治疗方法；ii）强调癌症的分子异质性以及靶向特定致癌途径的原理；iii）概述可能对胰腺癌治疗有潜在影响的靶向药物。
胰腺癌的分子发病机制涉及多种途径和特定的基因突变。用新型生物制剂和化疗药物联合靶向这些复杂的分子途径可能会改善患者的预后。
