Systemic therapy for metastatic pancreatic cancer

Pancreatic cancer (PC) is a complex and highly lethal malignancy. Surgery currently remains the only curative modality, although this cancer typically presents at advanced incurable stages. This obviates the use of definitive therapies and underscores the need for better systemic therapies. Unfortunately, limited progress has been made over the past decades with regard to effective treatment. Despite many clinical trials using combinations of various promising agents, there was no real improvement in outcomes until recently. Many of the molecular interactions involved were previously unrecognized and new approaches are now being investigated as a deeper understanding of the pathogenesis evolves. Newer therapies seeking to exploit known oncogenic pathways are being explored, along with alternate delivery mechanisms using conventional cytotoxic drugs.