Krug S, Michl P
Department of Gastroenterology, Endocrinology and Metabolism, Philipps University Marburg, Marburg, Germany.
Minerva Gastroenterol Dietol. 2012 Dec;58(4):427-43.
Pancreatic ductal adenocarcinomas belong to the most aggressive solid malignancies. The devastating prognosis of this tumor entity is associated with a high degree of resistance to systemic therapy approaches. Although new combination chemotherapy regimens have recently demonstrated a significant survival benefit compared to gemcitabine-based therapies, the search for novel treatment options still remains a huge challenge. After numerous potential targets have proven to be futile in clinical trials, recent efforts have been made to both improve drug delivery and to identify drugs targeting novel signalling pathways within the tumors including the putative stem cell compartment and the tumor stroma. Furthermore, predictive markers are needed to define tailored treatment regimens according to the molecular profile of individual tumors. In this review, current therapeutic strategies as well as emerging avenues for systemic therapy and response prediction for individualized therapy of pancreatic cancer patients are discussed which are currently evaluated to overcome the highly drug-resistant phenotype of this malignancy.
胰腺导管腺癌属于侵袭性最强的实体恶性肿瘤。该肿瘤实体的预后极差，与对全身治疗方法的高度耐药性相关。尽管与基于吉西他滨的疗法相比，新的联合化疗方案最近已显示出显著的生存获益，但寻找新的治疗选择仍然是一项巨大的挑战。在众多潜在靶点在临床试验中被证明无效之后，最近人们致力于改善药物递送，并识别针对肿瘤内包括假定干细胞区室和肿瘤基质在内的新信号通路的药物。此外，还需要预测性标志物来根据个体肿瘤的分子特征确定量身定制的治疗方案。在这篇综述中，讨论了目前针对胰腺癌患者进行全身治疗和反应预测以实现个体化治疗的治疗策略以及新出现的途径，这些目前正在评估中，以克服这种恶性肿瘤的高度耐药表型。
