Current Approaches and Future Strategies for Pancreatic Carcinoma

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Abstract
Pancreatic cancer is a lethal disease characterized bylocal invasion and early dissemination. It isresistant to conventional surgical, radiotherapeutic,and chemotherapeutic modalities. These interventionshave had minimal impact on overall survival with veryfew patients enjoying long term survival. Over thepast few years, 2′difluoro-2′deoxycytidine(gemcitabine) has demonstrated modest activity in thisdisease and investigations are proceeding to expandits role in combination with radiotherapy and otherchemotherapeutic agents. In addition, theidentification of the molecular defects underlyingthis disease has suggested molecular targets for thedesign of rational systemic therapy. These targetsinclude matrix metalloproteinases, K-ras, HER2/neu,p53, and the epidermal growth factorreceptor. Current and future clinical trials designedto improve the survival of patients with pancreaticcancer will be discussed.