Pancreatic cancer medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

The selection of a treatment intervention depends largely on the disease progression and the patient's stage of cancer. Chemotherapy may be employed when surgical intervention is not deemed appropriate.

Medical Therapy

• There are five different types of treatment for patients with pancreatic cancer.

• Surgery
• Radiation therapy
• Chemotherapy
• Chemoradiation therapy
• Targeted therapy

• New types of treatment are being tested in clinical trials.

• Biologic therapy

Chemotherapy

• Drugs Approved for Pancreatic Cancer

• Abraxane (Paclitaxel Albumin-stabilized Nanoparticle Formulation)
• Adrucil (Fluorouracil)

• Afinitor (Everolimus)
• Efudex (Fluorouracil)
• Erlotinib Hydrochloride
• Everolimus
• Fluoroplex (Fluorouracil)
• Fluorouracil
• Gemcitabine Hydrochloride
• Gemzar (Gemcitabine Hydrochloride)
• Mitomycin C
• Mitozytrex (Mitomycin C)
• Mutamycin (Mitomycin C)
• Paclitaxel Albumin-stabilized Nanoparticle Formulation
• Sunitinib Malate
• Sutent (Sunitinib Malate)
• Tarceva (Erlotinib Hydrochloride)

• Drug Combinations Used in Pancreatic Cancer

• FOLFIRINOX
• GEMCITABINE-CISPLATIN
• GEMCITABINE-OXALIPLATIN
• OFF(Oxaliplatin,Fluorouracil and Folinic Acid)

Nutritional supplements

A phase II clinical trial studying the effect of curcumin on pancreatic cancer was completed in 2007 and the results were published in 2008. The study used eight grams per day in 21 patients and stopped treatment if the tumor size increased. The conclusion of the study was "Oral curcumin is well tolerated and, despite its limited absorption, has biological activity in some patients with pancreatic cancer."

Radiation Therapy

The role of radiotherapy as an auxiliary (adjuvant) treatment after potentially curative surgery has been controversial since the 1980s. The European Society for Medical Oncology recommends that adjuvant radiotherapy should only be used for people enrolled in clinical trials. However there is a continuing tendency for clinicians in the US to be more ready to use adjuvant radiotherapy than those in Europe. Many clinical trials have tested a variety of treatment combinations since the 1980s, but have failed to settle the matter conclusively.

Radiotherapy may form part of treatment to attempt to shrink a tumor to a resectable state, but its use on unresectable tumors remains controversial as there are conflicting results from clinical trials. The preliminary results of one trial, presented in 2013, "markedly reduced enthusiasm" for its use on locally advanced tumors.

References

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