Tada M, Nakai Y, Sasaki T, Hamada T, Nagano R, Mohri D, Miyabayashi K, Yamamoto K, Kogure H, Kawakubo K, Ito Y, Yamamoto N, Sasahira N, Hirano K, Ijichi H, Tateishi K, Isayama H, Omata M, Koike K. Recent progress and limitations of chemotherapy for pancreatic and biliary tract cancers. World J Clin Oncol 2011; 2(3): 158-163 [PMID: 21611090 DOI: 10.5306/wjco.v2.i3.158]
Corresponding Author of This Article
Minoru Tada, MD, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo 113-8655, Japan. mtada-tky@umin.ac.jp
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Minoru Tada, Yousuke Nakai, Takashi Sasaki, Tsuyoshi Hamada, Rie Nagano, Dai Mohri, Koji Miyabayashi, Keisuke Yamamoto, Hirofumi Kogure, Kazumichi Kawakubo, Yukiko Ito, Natsuyo Yamamoto, Naoki Sasahira, Kenji Hirano, Hideaki Ijichi, Keishuke Tateishi, Hiroyuki Isayama, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
Masao Omata, Yamanashi Prefectural Hospital Organization, 400-8506 Yamanashi, Japan
Author contributions: Tada M, Nakai Y, Sasaki T and Isayama H designed the research; Tada M, Nakai Y, Sasaki T, Hamada T, Nagano R, Mohri D, Miyabayashi K, Yamamoto K, Kogure H, Kawakubo K, Ito Y, Yamamoto N, Sasahira N, Hirano K and Isayama H performed the research; Tada M, Nakai Y, Sasaki T analyzed the data; Tada M, Ijichi H and Tateishi K contributed molecular interruption of chemotherapy; Omata M and Koike K supervised the research and Tada M wrote the paper.
Correspondence to: Minoru Tada, MD, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku, Tokyo 113-8655, Japan. mtada-tky@umin.ac.jp
Telephone: +81-3-38155411 Fax: +81-3-38140021
Received: December 14, 2010 Revised: January 27, 2011 Accepted: February 3, 2011 Published online: March 10, 2011
Abstract
Gemcitabine chemotherapy has been the standard for advanced pancreatic cancer for more than a decade. New oral fluoropyrimidines such as S-1 and capecitabine are other key drugs. Gemcitabine plus erlotinib was the only combination therapy that significantly prolonged survival, although the effect was minimal. Little or no improvement in survival with recent molecular-targeted drugs might be attributed to the very high incidence of K-ras gene mutation in pancreatic cancer. Recently, the non-gemcitabine-based-regimen of FOLFIRINOX showed significantly greater overall survival compared with gemcitabine for the first time. For biliary tract cancer, gemcitabine plus cisplatin combination chemotherapy has been proved to significantly prolong survival and will become the standard therapy. Further improvement in survival is expected by the addition of cetuximab.
