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KMID : 1104820180060020064
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Journal of Digestive Cancer Research
2018 Volume.6 No. 2 p.64 ~ p.68
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Treatment for Metastatic Pancreatic Cancer
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Lee Bo-Young
Woo Sang-Myung
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Abstract
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Pancreatic ductal adenocarcinoma is a dismal prognosis and 5th leading cause of cancer related death in Korea. A large proportion of patients are diagnosed at advanced or metastatic stage. Therefore systemic chemotherapy has become the mainstay of treatment for pancreatic cancer. For most patients advanced or metastatic pancreatic cancer that has a good Eastern Cooperative Oncology Group performance status(ECOG PS) 0 or 1, we can recommend for FOLFIRINOX(leucovorin, 5-fluorouracil[5-FU], irinotecan and oxaliplatin) and gemcitabine plus nanoparticle albumin-bound paclitaxel(nab-paclitaxel). Currently, steps towards improved therapeutic efficacy of palliative chemotherapy have been made by introducing these regimens. For patients with an ECOG PS of 2, gemcitabine monotherapy or S1 alone is recommended. The second-line therapy for patients initially treated with gemcitabine-based chemotherapy includes provide FOLFOX(leucovorin, 5-FU, and oxaliplatin), capecitabine plus oxaliplatin, and 5-FU plus liposomal irinotecan. The gemcitabine-based chemotherapy is a reasonable choice for patients treated with FOLFIRINOX. Currently, studies on selecting patients for biomarkers related to molecular biologic features of tumors are underway for the realization of precise medicine, and the development and verification of preclinical models for the development of new therapeutic agents are being carried out continuously.
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KEYWORD
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Pancreatic cancer, Chemotherapy, Outcomes
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