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Title
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Novel therapeutic strategies in pancreatic cancer : moving beyond cytotoxic chemotherapy
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Author
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Abstract
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| Introduction: Prognosis of patients with metastatic pancreatic ductal adenocarcinoma (mPDAC) remains disappointing with a 5-year overall survival of only 3-5%. Compared to other cancers, the evolution in standard therapeutic options has been stagnant and polychemotherapy regimens (with well-known toxicity profile and resistance pattern) remain standard of care. Only for patients (5%-7%) with a breast cancer gene (BRCA) pathogenic germline variant, prognosis has improved by the use of olaparib (poly-ADP ribose polymerase (PARP) inhibitor).Areas covered: This review covers emerging treatment strategies in the management of mPDAC. One of the main topics is the rigid and immunological cold tumor microenvironment (TME) of PDAC and the search for agents that impact this TME and/or engage the immune system. In addition, the use of next-generation sequencing (NGS) has elicited for some patients new targeted therapies directed at alterations in the RTK/RAS/MAPK pathway and the deoxyribonucleic acid (DNA) damage repair pathway. Other evolving treatment strategies are also discussed.Expert opinion: The search for new, often combination, treatment strategies for mPDAC should be encouraged and implemented in early treatment lines given the significant decline of performance status of patients in later lines. NGS analysis should be used where available, although cost-effectiveness could be debatable. |
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Language
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English
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Source (journal)
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Expert review of anticancer therapy. - London, 2001, currens
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Publication
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Abingdon
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Taylor & francis ltd
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2023
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ISSN
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1473-7140
[print]
1744-8328
[online]
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DOI
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10.1080/14737140.2023.2270161
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Volume/pages
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23
:12
(2023)
, p. 1237-1249
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ISI
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001085726000001
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Pubmed ID
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37842857
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Full text (Publisher's DOI)
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