CURRENT AND FUTURE STRATEGIES FOR THERAPY OF PANCREATIC CANCER

Pancreatic cancer is a difficult and unsolved surgical problem pancreatic cancer is the fourth leading cause of cancer mortality in both men and women. Surgical resection is the only potential curative treatment. The median survival of this disease is between three and four months for untreated patients. However, in spite of treatment, less than 5% of patients are alive for five years. Because clinical symptoms are usually absent or aseptic in the early stage, it is frequently discovered at advanced or metastatic stage, only around 15-20% of tumors are resectable. In the majority of patients the chemotherapy offers a prolongation of life. Combination of various cytostatics did not produce a signicant improvement either. For that reason, continuous search for other agents is mandatory. Nowadays, in the era of molecular- targeted oncotherapeutic approaches, pancreatic cancer is also a subject of trials such as: epidermal growth factor receptor blockade (EGFR), inhibition of angiogenesis, modulation of tumor response through the extracellular matrix, inhibition of cyclooxygenase-2, fernery transferees inhibitors, signal transduction inhibitors, ablation of the hormonal impudence and some other aspects have all been studied, but to date, no breakthrough in the treatment of pancreatic carcinoma is proven. Trials on adjuvant and neo-adjuvant therapy of pancreatic cancerare also ongoing. This review presents the recent developments with newer chemotherapeutic and molecular-targeted agents, identifying the efforts for individualized treatment strategies. The ability to predict which patients would benefit most from surgical intervention and/or chemotherapy would be a great clinical asset.