Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Oct 15, 2023; 15(10): 1691-1705
Published online Oct 15, 2023. doi: 10.4251/wjgo.v15.i10.1691
Systemic treatment for advanced pancreatic cancer
Wattana Leowattana, Pathomthep Leowattana, Tawithep Leowattana
Wattana Leowattana, Pathomthep Leowattana, Department of Clinical Tropical Medicine, Mahidol University, Rachatawee 10400, Bangkok, Thailand
Tawithep Leowattana, Department of Medicine, Srinakharinwirot University, Wattana 10110, Bangkok, Thailand
Author contributions: Leowattana W wrote the paper; Leowattana T and Leowattana P collected the data.
Conflict-of-interest statement: The authors declare no conflicts of interest related to this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Wattana Leowattana, BMed, MD, MSc, PhD, Full Professor, Department of Clinical Tropical Medicine, Mahidol University, 420/6 Rajavithi Road, Rachatawee 10400, Bangkok, Thailand.
Received: July 11, 2023
Peer-review started: July 11, 2023
First decision: August 15, 2023
Revised: August 24, 2023
Accepted: September 22, 2023
Article in press: September 22, 2023
Published online: October 15, 2023

Pancreatic cancer is a deadly disease with an extremely poor 5-year survival rate due to treatment resistance and late-stage detection. Despite numerous years of research and pharmaceutical development, these figures have not changed. Treatment options for advanced pancreatic cancer are still limited. This illness is typically detected at a late stage, making curative surgical resection impossible. Chemotherapy is the most commonly utilized technique for treating advanced pancreatic cancer but has poor efficacy. Targeted therapy and immunotherapy have made significant progress in many other cancer types and have been proven to have extremely promising possibilities; these therapies also hold promise for pancreatic cancer. There is an urgent need for research into targeted treatment, immunotherapy, and cancer vaccines. In this review, we emphasize the foundational findings that have fueled the therapeutic strategy for advanced pancreatic cancer. We also address current advancements in targeted therapy, immunotherapy, and cancer vaccines, all of which continue to improve the clinical outcome of advanced pancreatic cancer. We believe that clinical translation of these novel treatments will improve the low survival rate of this deadly disease.

Keywords: Systemic treatment, Advanced pancreatic cancer, Personalized medicine, Biomarkers, Chemotherapy, Targeted therapy, Immunotherapy

Core Tip: Understanding the pathophysiology of pancreatic cancer and using personalized treatments might improve patients' overall survival. We think that targeted treatment, immunotherapy, and cancer vaccines can improve the prognosis of patients with advanced pancreatic cancer. As a result, additional study is required to identify the best combination of current drugs to help in early treatment and result in a better clinical outcome.