Fong Caroline Y K, Burke Emma, Cunningham David, Starling Naureen
The Royal Marsden NHS Foundation Trust, Downs Road, Sutton SM2 5PT, UK.
Gastroenterol Res Pract. 2019 Sep 5;2019:7135437. doi: 10.1155/2019/7135437. eCollection 2019.
Despite intensive research efforts, pancreatic ductal adenocarcinoma is still regarded as an aggressive and life-limiting malignancy. Combination chemotherapy regimens that underpin the current treatment approach in the advanced setting have led to incremental survival gains in recent years but have failed to confer patients with a median overall survival that exceeds 12 months from diagnosis. Research has since focussed on understanding the role and interplay between various components of the desmoplastic stroma and tumour microenvironment, in addition to developing targeted therapies based on molecular features to improve the prognosis associated with this malignancy. This review will summarise the available systemic treatment options and discuss potential methods to refine the resolution of patient selection to enhance responses to currently available therapies. Furthermore, it will explore newer approaches anticipated to come to the fore of future clinical practice, such as agents targeting the DNA damage response and tumour microenvironment as well as immunotherapy-based combinations.
尽管进行了深入的研究，但胰腺导管腺癌仍被视为一种侵袭性强、危及生命的恶性肿瘤。近年来，作为晚期胰腺癌当前治疗方法基础的联合化疗方案已使患者的生存期逐步延长，但仍无法使患者的中位总生存期超过自诊断起12个月。此后，研究重点转向了解促纤维增生性基质和肿瘤微环境各成分之间的作用及相互作用，同时开发基于分子特征的靶向治疗方法，以改善这种恶性肿瘤的预后。本综述将总结现有的全身治疗选择，并讨论优化患者选择策略以提高对现有疗法反应的潜在方法。此外，还将探讨有望在未来临床实践中崭露头角的新方法，如靶向DNA损伤反应和肿瘤微环境的药物以及基于免疫疗法的联合治疗。
