From the University of California San Francisco Comprehensive Cancer Center, San Francisco, CA.
J Clin Oncol. 2015 Jun 1;33(16):1779-86. doi: 10.1200/JCO.2014.59.7625. Epub 2015 Apr 27.
A growing number of therapeutic options are now available for patients with metastatic pancreatic cancer, informed by positive results from recently completed phase III clinical trials. These have led to modest, if not necessarily transformative, improvements in clinical outcomes. Although the standard of care for metastatic disease remains cytotoxic therapy, a variety of novel therapeutic approaches are currently under active investigation, several of which have already demonstrated encouraging results in phase I/II studies. The following three broad categories (with significant overlap among them) are highlighted here: stromal-depleting agents, immunotherapies, and signal transduction inhibitors. The mechanistic rationale, limitations, and promise of each of these strategies specific to pancreatic cancer are discussed, as are the aspects of this disease and this patient population that pose ongoing challenges in terms of both therapeutic management and biomarker-driven trial design.
越来越多的治疗选择现在可用于转移性胰腺癌患者，这是基于最近完成的 III 期临床试验的积极结果。这些结果导致临床结果有了适度的改善，如果不是必然的变革。尽管转移性疾病的标准治疗仍然是细胞毒性治疗，但目前正在积极研究各种新的治疗方法，其中一些在 I/II 期研究中已经显示出令人鼓舞的结果。这里重点介绍了以下三个广泛的类别（它们之间有很大的重叠）：基质耗竭剂、免疫疗法和信号转导抑制剂。讨论了每种策略针对胰腺癌的机制原理、局限性和前景，以及该疾病和患者群体在治疗管理和生物标志物驱动的试验设计方面持续存在的挑战。
