ADJUVANT AND SYSTEMIC THERAPY FOR PANCREATIC-CANCER

Pancreatic cancer remains a major cause of mortality. Less than 5% of patients survive 5 years. No curative therapy exists for patients not surgically resectable. Although chemotherapeutic and radiation therape utic approaches can provide palliation, they have not had a significan t impact on 5-year survival. Phase II and III studies are evaluating w hether newer approaches integrating chemotherapy, radiation therapy, a nd surgery will improve survival. Evaluation of new agents (e.g., camp tothecins, paclitaxel [and related compounds], gemcitabine, and thymyd ilate synthase inhibitors) alone and in combination with other agents (including platinum-related compounds) continue to be pursued. Novel a pproaches based on increased knowledge about biology of this disease, including high frequency of ras and p53 mutations or expression of a n umber of growth factor receptors, are being studied preclinically. App roaches utilizing vaccines, gene therapy, and cytokines to enhance the immune response are being developed. Hopefully, new approaches will l ead to improved treatment of this often fatal disease. (C) 1995 Wiley- Liss, Inc.