Dave Prashil, Beriwala Vishal, Parikh Charmy, Uddin Anwar, Dayala Hiren, Patel Raj H, Chirumamilla Punith Chowdary, Winer Andrew
Internal Medicine, State University of New York Downstate Health Sciences University, Brooklyn, USA.
Gastroenterology, Sardar Vallabhbhai Patel Institute of Medical Sciences and Research, Ahmedabad, IND.
Cureus. 2025 Jul 30;17(7):e89054. doi: 10.7759/cureus.89054. eCollection 2025 Jul.
Pancreatic cancer presents a formidable challenge in oncology, marked by its aggressive behavior and dismal prognosis. Despite a surge in global diagnoses, particularly in affluent nations, mortality data remain scarce in low-income countries due to limited access to diagnostic tools. The five-year survival rate remains dismally low, hovering around 6-8%, emphasizing the urgent need for innovative treatment strategies. In patients with resectable and borderline resectable pancreatic cancer, both neoadjuvant/perioperative mFOLFIRINOX and gemcitabine-nab-paclitaxel (GEM-Abraxane) have shown comparable median overall survival (23-25 months) and R0 resection rates (64-80%) in the SWOG S1505 trial. While mFOLFIRINOX demonstrates a modest progression-free survival benefit in metastatic settings, GEM-Abraxane remains a viable alternative, particularly in patients with borderline performance status. Metastasis, particularly in the lungs, is a common occurrence in pancreatic cancer, significantly impacting patient survival. Furthermore, bone metastasis, although less frequent, poses significant challenges and adversely affects outcomes. While the oncogene remains a dominant mutation, recent studies have identified additional actionable mutations (e.g., , , and fusions) that offer potential targets for precision therapy. Bispecific antibodies, such as anti-CD3/mesothelin and CD3/claudin-18.2, have demonstrated potent cytotoxic activity in preclinical pancreatic cancer models and are progressing into early-phase clinical trials. Innovative therapies, such as combination regimens and precision medicine approaches, show promise in improving outcomes for patients with advanced pancreatic cancer. The efficacy of novel agents targeting specific molecular pathways, including CLDN18.2 and PDGFRα, is currently being evaluated in early-phase trials (e.g., CT041, IMAB362). Additionally, metabolic interventions and immunotherapies aimed at modulating the tumor microenvironment hold significant potential to enhance treatment efficacy. While pancreatic cancer remains a formidable adversary, recent advancements in therapeutic strategies offer hope for improving patient outcomes by leveraging cutting-edge technologies and fostering collaborative research endeavors. This literature review focuses on the latest clinical trial results of novel therapies that have emerged for the management of pancreatic cancer.
胰腺癌是肿瘤学领域一项艰巨的挑战，其特点是侵袭性强且预后不佳。尽管全球胰腺癌诊断数量激增，尤其是在富裕国家，但由于低收入国家获取诊断工具的机会有限，死亡率数据仍然匮乏。五年生存率依然极低，徘徊在6%-8%左右，这凸显了对创新治疗策略的迫切需求。在可切除和临界可切除的胰腺癌患者中，新辅助/围手术期mFOLFIRINOX方案和吉西他滨-纳米白蛋白结合型紫杉醇（GEM-艾日布林）在SWOG S1505试验中显示出相当的中位总生存期（约23-25个月）和R0切除率（约64%-80%）。虽然mFOLFIRINOX在转移性胰腺癌中显示出适度的无进展生存期获益，但GEM-艾日布林仍是一种可行的选择，特别是对于身体状况临界的患者。转移，尤其是肺转移，在胰腺癌中很常见，会显著影响患者生存。此外，骨转移虽然不太常见，但也带来了重大挑战并对治疗结果产生不利影响。虽然癌基因仍然是主要的突变类型，但最近的研究已经确定了其他可靶向治疗的突变（如、和融合），这些突变为精准治疗提供了潜在靶点。双特异性抗体，如抗CD3/间皮素和CD3/紧密连接蛋白18.2，在临床前胰腺癌模型中已显示出强大的细胞毒性活性，并且正在进入早期临床试验阶段。创新疗法，如联合治疗方案和精准医学方法，在改善晚期胰腺癌患者的治疗结果方面显示出前景。目前正在早期试验（如CT041、IMAB362）中评估针对特定分子途径（包括CLDN18.2和PDGFRα）的新型药物的疗效。此外，旨在调节肿瘤微环境的代谢干预和免疫疗法具有显著提高治疗效果的潜力。虽然胰腺癌仍然是一个强大的对手，但治疗策略的最新进展为通过利用前沿技术和促进合作研究努力来改善患者治疗结果带来了希望。这篇文献综述重点关注了针对胰腺癌治疗出现的新型疗法的最新临床试验结果。
