Division of Oncology, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA.
Division of Oncology, Department of Medicine, Campus Box 8056, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 63110, USA.
Ther Adv Med Oncol. 2015 Mar;7(2):68-84. doi: 10.1177/1758834014564775.
Pancreatic adenocarcinoma is one of the deadliest solid malignancies. A large proportion of patients are diagnosed with locally advanced or metastatic disease at the time of presentation and, unfortunately, this severely limits the number of patients who can undergo surgical resection, which offers the only chance for cure. Recent therapeutic advances for patients with advanced pancreatic cancer have extended overall survival, but prognosis still remains grim. Given that traditional chemotherapy is ineffective in curing advanced pancreatic adenocarcinoma, current research is taking a multidirectional approach in the hopes of developing more effective treatments. This article reviews the major clinical trial data that is the basis for the current chemotherapy regimens used as first- and second-line treatments for advanced pancreatic adenocarcinoma. We also review the current ongoing clinical trials, which include the use of agents targeting the oncogenic network signaling of K-Ras, agents targeting the extracellular matrix, and immune therapies.
胰腺腺癌是最致命的实体恶性肿瘤之一。很大一部分患者在就诊时被诊断为局部晚期或转移性疾病，不幸的是，这严重限制了能够接受手术切除的患者数量，而手术切除是唯一治愈的机会。最近针对晚期胰腺癌患者的治疗进展延长了总体生存时间，但预后仍然严峻。鉴于传统化疗在治愈晚期胰腺腺癌方面无效，目前的研究正在采取多方位的方法，希望开发更有效的治疗方法。本文综述了目前用于治疗晚期胰腺腺癌的一线和二线治疗方案的主要临床试验数据。我们还综述了目前正在进行的临床试验，包括针对致癌网络信号 KRas 的靶向药物、针对细胞外基质的靶向药物和免疫疗法。
