Recent advances in chemotherapy for pancreatic cancer: evidence from Japan and recommendations in guidelines

J Gastroenterol. 2020 Apr;55(4):369-382. doi: 10.1007/s00535-020-01666-y. Epub 2020 Jan 29.

Abstract

The prognosis of patients with pancreatic cancer continues to remain dismal, even though numerous trials have been conducted to establish more effective therapies in Japan and throughout the world. Recent advances in treatment have been characterized by the use of novel combinations of conventional cytotoxic chemotherapies. Especially in Japan, S-1 has become one of the most widely used cytotoxic agents for the treatment of pancreatic cancer, after clinical evidence was established of the survival benefit offered by this drug for patients with resectable or unresectable pancreatic cancer. Unfortunately, with the exception of erlotinib, no targeted treatment strategies have been approved for pancreatic cancer. However, following an increase in interest in drug development in recent years, proactive attempts have been made to develop new therapeutic strategies, including neoadjuvant chemotherapy for patients with resectable or borderline resectable pancreatic cancer, multi-agent combination chemotherapy for patients with advanced pancreatic cancer, and therapies with new targeted agents or immuno-oncologic agents for patients with pancreatic cancer bearing specific gene mutations.

Keywords: Actionable mutation; Adjuvant therapy; Immunotherapy; Pancreatic ductal adenocarcinoma; Targeted therapy.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Immunological / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Chemotherapy, Adjuvant
  • Disease-Free Survival
  • Humans
  • Japan
  • Molecular Targeted Therapy*
  • Neoadjuvant Therapy
  • Neoplasm Invasiveness
  • Neoplasm Metastasis
  • Pancreatic Neoplasms / drug therapy*
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery
  • Practice Guidelines as Topic
  • Randomized Controlled Trials as Topic
  • Survival Rate

Substances

  • Antineoplastic Agents, Immunological