Current approaches and future strategies for pancreatic carcinoma

Pancreatic cancer is a lethal disease characterized by local invasion and e arly dissemination. It is resistant to conventional surgical, radiotherapeu tic, and chemotherapeutic modalities. These interventions have had minimal impact on overall survival with very few patients enjoying long term surviv al. Over the past few years, 2'difluoro-2'deoxycytidine (gemcitabine) has d emonstrated modest activity in this disease and investigations are proceedi ng to expand its role in combination with radiotherapy and other chemothera peutic agents. In addition, the identification of the molecular defects und erlying this disease has suggested molecular targets for the design of rati onal systemic therapy. These targets include matrix metalloproteinases, K-r as, HER2/neu, p53, and the epidermal growth factor receptor. Current and fu ture clinical trials designed to improve the survival of patients with panc reatic cancer will be discussed.