New Therapeutic Strategies in the Second Line Setting of Advanced or Metastatic Pancreatic Adenocarcinoma
Pancreatic cancer is a lethal disease and its prognosis remains dismal. The modest results of existing available treatments in the second line setting reveal the need of new therapeutic strategies. In this year’s American Society of Clinical Oncology (ASCO) Annual Meeting two remarkable trials and one retrospective analysis were presented regarding this vulnerable group of patients. According to the published results, docetaxel plus oxaliplatin (Abstract #4034), selumetinib plus erlotinib (Abstract #4014) and nab-paclitaxel (Abstract #e15057) have shown promising efficacy and manageable toxicity that should be elucidated and confirmed by new prospective, large, randomized trials.
Image: Therapeutic strategies in second line setting of advanced or metastatic pancreatic adenocarcinoma.
Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013 Jan;63(1):11-30. doi: 10.3322/caac.21166. Epub 2013 Jan 17.
Pelzer U, Schwaner I, Stieler J, Adler M, Seraphin J, Dörken B, Riess H, Oettle H. Best supportive care (BSC) versus oxaliplatin, folinic acid and 5-fluorouracil (OFF) plus BSC in patients for second-line advanced pancreatic cancer: a phase III-study from the German CONKO-study group. Eur J Cancer. 2011 Jul;47(11):1676-81. doi: 10.1016/j.ejca.2011.04.011. Epub 2011 May 10.
Xiong HQ, Varadhachary GR, Blais JC, Hess KR, Abbruzzese JL, Wolff RA. Phase 2 trial of oxaliplatin plus capecitabine (XELOX) as second-line therapy for patients with advanced pancreatic cancer. Cancer. 2008 Oct 15;113(8):2046-52. doi: 10.1002/cncr.23810.
Maisey N, Chau I, Cunningham D, et al. Multicenter randomized phase III trial comparing protracted venous infusion (PVI) fluorouracil (5-FU) with PVI 5-FU plus mitomycin in inoperable pancreatic cancer. J Clin Oncol 2002;20:3130-3136
Ettrich T, Goetz von Wichert, Gress T, Michl P, Geissler M, Hebart H, et al. DOCOX: A phase II trial with docetaxel and oxaliplatin as a second-line systemic therapy for patients with advanced and/or metastatic adenocarcinoma of the pancreas. J Clin Oncol 31, 2013 (suppl; abstr 4034)
Ko A, Tempero M, Bekaii-Saab T, Kuhn P, Courtin R, Ziyeh S, et al. Dual MEK/EGFR inhibition for advanced, chemotherapy-refractory pancreatic cancer: A multicenter phase II trial of selumetinib (AZD6244; ARRY-142886) plus erlotinib. J Clin Oncol 31, 2013 (suppl; abstr 4014)
Diep CH, Munoz RM, Choudhary A, Von Hoff DD, Han H. Synergistic effect between erlotinib and MEK inhibitors in KRAS wild-type human pancreatic cancer cells. Clin Cancer Res. 2011 May 1;17(9):2744-56.
Vaccaro V, Bria E, Reni M, Sperduti I, Gelibter A, Nuzzo C, et al. Activity of nab-paclitaxel (nab-P) monotherapy in heavily pretreated pancreatic cancer (aPDAC) patients (pts): A multicenter retrospective analysis. J Clin Oncol 31, 2013 (suppl; abstr e15057)
Copyright (c) 2014 Vasilis Stefanos Ramfidis, Kostas N Syrigos, Muhammad Wasif Saif
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