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The Medical Management of Pancreatic Cancer: A Review

Department of Oncology, Belfast City Hospital, Belfast, Northern Ireland

Correspondence: Martin Eatock, M.D., Department of Oncology, Belfast City Hospital, Lisburn Road, Belfast BT9 7AB, Northern Ireland. Telephone: 02890-329241 ext 3911; Fax: 02890-263744; e-mail: MartinEatock{at}bch.n-i.nhs.uk

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.

Key Words. Pancreatic ductal carcinoma • Antineoplastic agents • Tissue inhibitor of metalloproteinases • Epidermal growth factor receptor • ras gene • Angiogenesis inhibitors

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