The Medical Management of Pancreatic Cancer: A Review

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Abstract
Learning Objectives: After completing this course, the reader will be able to: Understand the clinical problems associated with treating pancreatic cancer. Appreciate the role of chemotherapy in the treatment of pancreatic cancer. Appreciate the rational for the investigation of a number of novel agents in this disease. Access and take the CME test online and receive one hour of AMA PRA category 1 credit at CME.TheOncologist.com Pancreatic carcinoma is a commonly occurring cancer that tends to present late in its course when potentially curative surgical treatment is not possible. The majority of patients are, therefore, candidates for systemic therapy. We review the patient and disease-related factors that contribute to the difficulties in the medical management of this condition and discuss new methods of assessing response to treatment, including the introduction of more clinically relevant novel end points such as clinical benefit response. We review the current trial literature examining the use of conventional cytotoxic agents in this disease, both as single agents and in combination. We also review the use of more novel targeted agents and examine their potential utility in this disease. The use of the farnesyl transferase inhibitors, matrix metalloproteinase inhibitors, epidermal growth factor receptor antagonists, and angiogenesis inhibitors is discussed.