First-Line Treatment of Metastatic Pancreatic Adenocarcinoma: Can We Do Better?

  • Man Yee Merl Yale-New Haven Hospital. New Haven, CT, USA
  • Osama Abdelghany Yale-New Haven Hospital. New Haven, CT, USA
  • Jia Li Yale Cancer Center, Yale University School of Medicine. New Haven, CT, USA
  • Muhammad Wasif Saif Yale Cancer Center, Yale University School of Medicine. New Haven, CT, USA
Keywords: erlotinib, gemcitabine, Neoplasm Metastasis, Pancreatic Neoplasms


Pancreatic cancer is one of the most devastating solid tumor malignancies. Majority of patients have metastatic disease upon diagnosis. Five-year survival is less than 5% for all stages of pancreatic cancer combined. Gemcitabine has been the standard palliative therapy for advanced pancreatic cancer over the past decade. Many studies attempted to develop combination regimens, but they failed to improve overall survival in the metastatic settings. The combination of gemcitabine and erlotinib was the first combination regimen to show improvements in survival benefit compared with gemcitabine alone and became the first-line combination therapy in advanced pancreatic cancer. The search for better treatment strategies to prolong survival in this deadly disease is very much needed and is a worldwide effort. There were many studies presented at the 2010 American Society of Clinical Oncology (ASCO) Annual Meeting focused on first-line therapy in metastatic pancreatic cancer. This article highlights a few phase III and II studies that have demonstrated encouraging results.

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Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer Statistics, 2009. CA Cancer J Clin 2009; 59:225-49. [PMID 19474385]

National Cancer Institute. Pancreatic Cancer Treatment (PDQ®). Health Professional Version. Bethesda, MD, USA. (Accessed: June 12, 2010).

Evans DB, Abbruzzese JL, Willett CG. Cancer of the pancreas. In: DeVita VT, Hellman S, Rosenberg SA (editors). Cancer: Principles and Practice of Oncology. 6th ed. Vol. 1. Philadelphia: Lippincott, Williams & Wilkins; 1997. p. 1126-61. [ISBN 0-7817-7207-9]

Burris HA 3rd, Moore MJ, Andersen J, Green MR, Rothenberg ML, Modiano MR, et al. Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol 1997; 15:2403-13. [PMID 9196156]

Stathis A, Moore MJ. Advanced pancreatic carcinoma: current treatment and future challenges. Nat Rev Clin Oncol 2010; 7:163-72. [PMID 20101258]

Moore MJ, Goldstein D, Hamm J, Figer A, Hecht JR, Gallinger S, et al. Erlotinib plus gemcitabine compared with gemcitabine alone in patients with advanced pancreatic cancer: a phase III trial of the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol 2007; 25:1960-6. [PMID 17452677]

Conroy T, Desseigne F, Ychou M, Ducreux M, Bouche O, Guimbaud R, et al. Randomized phase III trial comparing FOLFIRINOX (F: 5FU/leucovorin [LV], irinotecan [I], and oxaliplatin [O]) versus gemcitabine (G) as first-line treatment for metastatic pancreatic adenocarcinoma (MPA): Preplanned interim analysis results of the PRODIGE 4/ACCORD 11 trial. J Clin Oncol 2010; 28(15 Suppl):4010.

Boeck SH, Vehling-Kaiser U, Waldschmidt D, Kettner E, Märten A, Winkelmann C, et al. Gemcitabine plus erlotinib (GE) followed by capecitabine (C) versus capecitabine plus erlotinib (CE) followed by gemcitabine (G) in advanced pancreatic cancer (APC): A randomized, cross-over phase III trial of the Arbeitsgemeinschaft Internistische Onkologie (AIO). J Clin Oncol 2010; 28(18 Suppl):LBA4011.

Watkins DJ, Starling N, Chau I, Thomas J, Webb J, Oates JR, et al. The combination of a chemotherapy doublet (gemcitabine plus capecitabine) with a biologic doublet (bevacizumab plus erlotinib) in patients with advanced pancreatic adenocarcinoma: The TARGET study. J Clin Oncol 2010; 28(15 Suppl):4036.

Nakai Y, Isayama H, Sasaki T, Sasahira N, Hirano K, Tsujino T, et al. A multicenter randomized controlled trial of gemcitabine (G) alone versus gemcitabine and S-1 combination therapy (GS) in patients with unresectable advanced pancreatic cancer (PC): GEMSAP study. J Clin Oncol 2010; 28(15 Suppl):4037.

Yale-New Haven Hospital. New Haven, CT, USA
How to Cite
MerlM., AbdelghanyO., LiJ., & SaifM. (2010). First-Line Treatment of Metastatic Pancreatic Adenocarcinoma: Can We Do Better?. JOP. Journal of the Pancreas, 11(4), 317-320.
Highlights from the “2010 ASCO Annual Meeting”. Chicago, IL, USA. June 4-8, 2010

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