Chemotherapy in the treatment of pancreatic cancer (also known as pancreatic adenocarcinoma) is applicable in at least three settings:
- Metastatic disease
- Locally advanced unresectable disease
- As adjuvant chemotherapy
However, chemotherapy treatment for pancreatic cancer in any setting has demonstrated a limited efficacy, and in fact there is little difference in the agents used or the stage at which they're often given.
Standard front-line chemotherapy for metastatic disease is gemcitabine (marketed as Gemzar), although a small variety of combinations with gemcitabine have shown some potential, and they include:
- Gemcitabine + erlotinib
- Gemcitabine + cisplatin
- Gemcitabine + oxaliplatin
- Gemcitabine + fluoropyrrimidine
Second-line chemotherapy may involve one or more of the following agents:
- 5-FU/leucovorin
- Capecitabine
- Oxaliplatin + 5-FU/leucovorin
Locally advanced unresectable disease
Chemoradiation (or radiochemotherapy) involving 5-FU/leucovorin is a common front-line treatment for locally advanced pancreatic cancers, and this may be preceded by gemcitabine-based chemotherapy.
As adjuvant chemotherapy
Adjuvant chemotherapy in the treatment of pancreatic cancer is not well-understood, and the chemotherapeutic agents aren't any different than they are in any other setting for this disease; still, for some patients gemcitabine or 5-FU/leucovorin are used post-surgery.
References
- Boyiadzis, Michael M. et al. Hematology-Oncology Therapy. 2007. New York: McGraw Hill, Medical Publishing Division.
- Ko, Andrew H MD et al. 2008. Everyone's Guide to Cancer Therapy, Fifth Ed. Kansas City. Andres McMeel Publishing LLC.
- National Comprehensive Cancer Network: Clinical Practice Guidelines in Oncology- V.2.2010. Pancreatic adenocarcinoma
Related Articles
Pancreas cancer survival rate
