Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 14, 2015; 21(38): 10709-10713
Published online Oct 14, 2015. doi: 10.3748/wjg.v21.i38.10709
Advanced pancreatic cancer - how to choose an adequate treatment option
Eija A Korkeila
Eija A Korkeila, Department of Oncology, Turku University Hospital and University of Turku, 20521 Turku, Finland
Author contributions: Korkeila EA wrote this manuscript.
Conflict-of-interest statement: The author Eija A Korkeila has received a fee for serving as a speaker and an advisory board member for Abbott and Roche.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Eija A Korkeila, MD, PhD, Specialist in Oncology and Radiotherapy, Department of Oncology, Turku University Hospital and University of Turku, Hämeentie 11 PB 52, 20521 Turku, Finland. eija.korkeila@tyks.fi
Telephone: +358-2-3130000 Fax: +358-2-3132850
Received: January 31, 2015
Peer-review started: February 1, 2015
First decision: April 13, 2015
Revised: May 26, 2015
Accepted: August 25, 2015
Article in press: August 25, 2015
Published online: October 14, 2015
Processing time: 255 Days and 19.7 Hours
Abstract

The prognosis of pancreatic adenocarcinoma is poor, making it one of the leading causes of cancer-related death. The 5-year overall survival rate remains below 5% and little progress is made during the past decade. Only about 10%-20% of patients are eligible for curative-intent surgery and the majority end up having recurring disease even after radical surgery and postoperative adjuvant chemotherapy. Chemotherapy in metastatic disease is palliative at best, aiming at disease and symptom control and prolongation of life. Treatment always causes side effects, the degree of which varies from patient to patient, depending on the patient’s general condition, concomitant morbidities as well as on the chosen treatment modality. Why is pancreatic cancer so resistant to treatment? How to best help the patient to reach the set treatment goals?

Keywords: Pancreatic cancer; Chemotherapy; Palliative treatment; Prognosis; Side effects

Core tip: The prognosis of metastatic pancreatic adenocarcinoma is poor. Chemotherapy is palliative at best. Some patients benefit from treatment, while some have rapidly progressing treatment-resistant disease. There are several options for single-agent and combined treatment. Some patients may even gain benefit from treatment in second and even further lines and live substantially longer than average. Why is pancreatic cancer so resistant to treatment?