ISSN: 1837-9664Journal of Cancer
Global reach, higher impact
J Cancer 2024; 15(8):2214-2228. doi:10.7150/jca.89788 This issue Cite
Review
Advances in Drug Therapy for Metastatic Pancreatic Ductal Adenocarcinoma
1. Department of Hepatopancreatobiliary Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, Heilongjiang, China.
2. Department of General Surgery, Tangdu Hospital, Air Force Medical University, Xi'an 710032, Shanxi, China.
3. Key Laboratory of Basic Pharmacology of Ministry of Education, Zunyi Medical University, Zunyi, 563006, Guizhou, China.
4. Key Laboratory of Functional and Clinical Translational Medicine, Fujian Province University, Xiamen Medical College, Xiamen, 361000, Fujian, China.
5. State Key Laboratory of Chemical Oncogenomics, Key Laboratory of Chemical Genomics, Peking University Shenzhen Graduate School, Shenzhen, 518055, Guangzhou, China.
6. Jiangsu Province Engineering Research Center of Tumor Targeted Nano Diagnostic and Therapeutic Materials, Yancheng Teachers University, Yancheng, 224007, Jiangsu, China.
7. Key Laboratory of Biomarkers and In Vitro Diagnosis Translation of Zhejiang province, Hangzhou,310000, Zhejiang, China.
8. Key Laboratory of Gastrointestinal Cancer, Fujian Medical University, Ministry of Education, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, 350122, Fujian, China.
9. School of Health Administration, Harbin Medical University, Harbin 150086, Heilongjiang, China.
# These authors contributed equally to this work.
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive disease with a notably poor prognosis. A large number of patients with PDAC develop metastases before they are diagnosed with metastatic pancreatic cancer (mPDAC). For mPDAC, FOLFIRINOX or gemcitabine plus nab-paclitaxel are the current first-line treatments. It is important to note, however, that many patients will fail chemotherapy because of drug resistance. Heterogeneous tumors and complex tumor microenvironments are key factors. As a result, clinical researchers are exploring a variety of alternative treatment modalities. Current understanding of the molecular signature and immune landscape of PDAC has motivated the emergence of different targeted and immune-based therapeutic approaches, some of which have shown promising results. The purpose of this review is to discuss the new targets and new drugs for mPDAC in terms of specific pathogenic factors such as metabolic vulnerability, DNA damage repair system, tumor microenvironment and immune system, in order to identify potential vulnerabilities in mPDAC patients and hopefully improve the prognosis of mPDAC patients.
Keywords: metastatic pancreatic cancer, metabolic pathways, DNA damage systems, tumor microenvironment, immune system
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