SYSTEMIC AND ADJUVANT THERAPY FOR PATIENTS WITH PANCREATIC-CARCINOMA

BACKGROUND. Pancreatic cancer is a highly lethal disease with less tha n or equal to 5% of patients surviving 5 years. There is no curative t herapy for patients who cannot be surgically resected. Chemotherapy an d radiation therapy can provide palliation but have not had a signific ant impact on 5-year survival. METHODS. Newer approaches for improving the survival of patients with pancreatic cancer integrating chemother apy, radiation therapy, and surgery are being evaluated. New chemother apeutic agents (e.g., gemcitabine, camptothecins, taxanes, thymydilate synthase inhibitors, and fluorouracil-related compounds) are being st udied alone and in combination with each other or different agents (e. g., trimetrexate or platinum-related compounds). RESULTS. Increased kn owledge about the biology of pancreatic cancer (including high frequen cy of ras and p53 mutations in neoplastic cells or the expression of a number of growth factor receptors on the cell surface) has lead to pr eclinical evaluation of novel approaches attempting to specifically ta rget these. These novel approaches include gene therapy, vaccines, and antisense oligonucleotides targeted to genes important for proliferat ion or survival of pancreatic cancer cells. CONCLUSIONS. Continued dev elopment of new approaches is needed to improve the treatment and surv ival of patients with pancreatic cancer. (C) 1996 American Cancer Soci ety.