Comprehensive Cancer Center Vienna, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
Pancreas. 2013 Jul;42(5):760-73. doi: 10.1097/MPA.0b013e31827aedef.
Pancreatic cancer is the fourth leading cause of cancer-related death. Most patients present with an advanced stage of disease that has a dismal outcome, with a median survival of approximately 6 months. Evidently, there is a clear need for the development of new agents with novel mechanisms of action in this disease. A number of biological agents modulating different signal transduction pathways are currently in clinical development, inhibiting angiogenesis and targeting epidermal growth factor receptor, cell cycle, matrix metalloproteinases, cyclooxygenase-2, mammalian target of rapamycin, or proteasome. This is the first systematic review of the literature to synthesize all available data coming from trials and evaluate the efficacy and safety of molecular targeted drugs in unresectable and metastatic pancreatic cancer. However, it should be stressed that although multiple agents have been tested, only 9 phase 3 trials have been conducted and one agent (erlotinib) has been approved by the Food and Drug Administration for use in clinical practice. As knowledge accumulates on the molecular mechanisms underlying carcinogenesis in the pancreas, the anticipated development and assessment of molecularly targeted agents may offer a promising perspective for a disease which, to date, remains incurable.
胰腺癌是癌症相关死亡的第四大主要原因。大多数患者就诊时已处于疾病晚期，预后极差，中位生存期约为 6 个月。显然，这种疾病迫切需要开发具有新型作用机制的新药物。目前有许多调节不同信号转导通路的生物制剂正在临床开发中，这些药物通过抑制血管生成和靶向表皮生长因子受体、细胞周期、基质金属蛋白酶、环氧化酶-2、哺乳动物雷帕霉素靶蛋白或蛋白酶体来发挥作用。这是首次对文献进行的系统性综述，综合了来自试验的所有可用数据，并评估了不可切除和转移性胰腺癌中分子靶向药物的疗效和安全性。然而，应该强调的是，尽管已经测试了多种药物，但仅进行了 9 项 3 期临床试验，并且只有一种药物（厄洛替尼）已被美国食品和药物管理局批准用于临床实践。随着对胰腺发生癌变的分子机制的认识不断增加，预期开发和评估分子靶向药物可能为这种迄今仍无法治愈的疾病提供一个有前景的治疗方案。
