AGITG 2013* Uppdate in Pancreatic cancer chemotherapy in advanced disease (10453)
Pancreatic Carcinoma continues to be a problematic malignancy characterised by poor long term survival, late diagnosis and resistance to systemic therapy. Nevertheless meaningful advances in treatment have occurred. Novel combination regimens including both Folfirinox and Gemcitabine and Abraxane in the first line setting have been associated with clinically meaningful changes in response rate and survival compared to the previous standard of Gemcitabine monotherapy. The increase in choices of initial regimens has also been associated with the identification of active second line therapy. The contribution of targeted therapy as an avenue for investigation remains uncertain, to date only EGFR blockade has shown any significant albeit small incremental benefit. Novel strategies to enrich target populations are likely to enhance the value of these drugs. The role of radiation in locally advanced disease remains unclear with no benefit seen as a routine choice using current schedules. The challenge is in identifying any subset that may benefit. The clear advances in the advanced setting are now in the process of testing as adjuvant therapy where they may have their greatest survival impact. The future continues to depend upon emerging advances in basic biology.
