Is metastatic pancreatic cancer an untargetable malignancy?

doi:10.4251/wjgo.v8.i3.297

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World Journal of Gastrointestinal Oncology

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1948-5204

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World J Gastrointest Oncol. Mar 15, 2016; 8(3): 297-304
Published online Mar 15, 2016. doi: 10.4251/wjgo.v8.i3.297

Is metastatic pancreatic cancer an untargetable malignancy?

Hampig Raphael Kourie, Joseph Gharios, Fadi Elkarak, Joelle Antoun, Marwan Ghosn

Hampig Raphael Kourie, Joseph Gharios, Fadi Elkarak, Joelle Antoun, Marwan Ghosn, Department of Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon

Author contributions: Kourie HR and Ghosn M initiated the review; Kourie HR, Gharios J and Ghosn M performed the review, wrote and analyzed the data; Kourie HR, Gharios J, Elkarak F, Antoun J and Ghosn M reviewed the paper.

Conflict-of-interest statement: Authors confirm that they do not have any conflict of interest.

Correspondence to: Marwan Ghosn, MD, Department of Oncology, Faculty of Medicine, Saint Joseph University, Monot St, PO Box 166830, Beirut, Lebanon. marwanghonmd@yahoo.com

Telephone: +961-1-3226842 Fax: +961-1-1613397

Received: June 29, 2015
Peer-review started: July 2, 2015
First decision: September 22, 2015
Revised: November 9, 2015
Accepted: December 18, 2015
Article in press: December 21, 2015
Published online: March 15, 2016
Processing time: 252 Days and 6.2 Hours

Abstract

Metastatic pancreatic cancer (MPC) is one of the most aggressive malignancies, known to be chemo-resistant and have been recently considered resistant to some targeted therapies (TT). Erlotinib combined to gemcitabine is the only targeted therapy that showed an overall survival benefit in MPC. New targets and therapeutic approaches, based on new-TT, are actually being evaluated in MPC going from immunotherapy, epigenetics, tumor suppressor gene and oncogenes to stromal matrix regulators. We aim in this paper to present the major causes rendering MPC an untargetable malignancy and to focus on the new therapeutic modalities based on TT in MPC.

Keywords: Pancreatic cancer; Tumor suppressor genes; Targeted therapies; Immunotherapy; Epigenetics

Core tip: This paper will report on the most recent updates in the treatment of metastatic pancreatic cancer (MPC). We present the major causes rendering MPC an untargetable malignancy and we focus on the new therapeutic modalities based on targeted therapies in MPC.