| Theme |
Pancreatic Cancer : Up-to-date |
| Title |
Chemotherapy for Inoperable Advanced Pancreatic Cancer |
| Author |
Satoru Hirokawa |
Medical Oncology Division, Kyorin University School of Medicine |
| Author |
Hiroshi Kitamura |
Medical Oncology Division, Kyorin University School of Medicine |
| Author |
Fumio Nagashima |
Medical Oncology Division, Kyorin University School of Medicine |
| Author |
Junji Furuse |
Medical Oncology Division, Kyorin University School of Medicine |
| [ Summary ] |
Pancreatic cancer is one of the most devastating diseases. In addition, the incidence of this condition continues to increase. Since gemcitabine was confirmed to provide a survival advantage over 5-FU in patients with unresectable advanced pancreatic cancer, it has become widely used as the standard first-line chemotherapy. However, the advantages in terms of survival are inadequate, and various chemotherapeutic regimens have been investigated in clinical studies in an effort to prolong survival times. Many regimens combining gemcitabine and molecular targeted agents have been investigated. Only a combination of gemcitabine and erlotinib exhibited statistically significant survival benefits, compared to gemcitabine alone. However, the difference was very small and serious interstitial pneumonia was frequently observed. Erlotinib, therefore, has not been approved in Japan for pancreatic cancer treatment. Recently, a regimen of FOLFIRINOX has been shown to provide a significant survival advantage in a randomized clinical trials compared to gemcitabine. Based on evidence from randomized clinical trials, chemoradiotherapy using 5-FU has been recognized as the standard therapy for unresectable locally advanced pancreatic cancer sincethe 1980s. However, gemcitabine is now considered to be the standard therapy for locally advanced pancreatic cancer. New chemoradiaotherapy methods such as S-1 concurrent chemoradiotherapy are currently under investigation to improve survival rates for patients with locally advanced disease. |