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. 2018 Jul 11;54(3):48.
doi: 10.3390/medicina54030048.

Chemotherapy in Pancreatic Cancer: A Systematic Review

Leva Hajatdoost  1 , Keyvan Sedaghat  2 , Erin J Walker  3 , Jackson Thomas  4 , Sam Kosari  5
Affiliations

Chemotherapy in Pancreatic Cancer: A Systematic Review

Leva Hajatdoost et al. Medicina (Kaunas). .

Abstract

Background and aim: Pancreatic cancer is one of the most fatal cancers. Cytotoxic chemotherapy remains the mainstream treatment for unresectable pancreatic cancer. This systematic review evaluated and compared the overall survival (OS) and progression-free survival (PFS) outcomes obtained from recent phase 2 and 3 clinical trials of pancreatic cancer chemotherapy.

Materials and methods: Thirty-two studies were included and compared based on chemotherapy agents or combinations used. Additionally, outcomes of first-line versus second-line chemotherapy in pancreatic cancer were compared.

Results: In studies that investigated the treatments in adjuvant settings, the highest OS reported was for S-1 in patients, who received prior surgical resection (46.5 months). In neoadjuvant settings, the combination of gemcitabine, docetaxel, and capecitabine prior to the surgical resection had promising outcomes (OS of 32.5 months). In non-adjuvant settings, the highest OS reported was for the combination of temsirolimus plus bevacizumab (34.0 months). Amongst studies that investigated second-line treatment, the highest OS reported was for the combination of gemcitabine plus cisplatin (35.5 months), then temsirolimus plus bevacizumab (34.0 months).

Conclusions: There is a need to develop further strategies besides chemotherapy to improve the outcomes in pancreatic cancer treatment. Future studies should consider surgical interventions, combination chemotherapy, and individualized second-line treatment based on the prior chemotherapy.

Keywords: chemotherapy; first-line treatment; pancreatic cancer; second-line treatment; survival.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram. OS—overall survival; PFS—progression-free survival.
Figure 2
Figure 2
Comparison between the OS and PFS for different combinations of gemcitabine with other agents. PC*: pancreatic cancer; 5FU: 5-fluorouracil.
Figure 3
Figure 3
Comparison between the OS and PFS for different combinations of capecitabine with other agents except gemcitabine.
Figure 4
Figure 4
Comparison between the OS and PFS for the other drug combinations (except gemcitabine and capecitabine). *PC: pancreatic cancer. LGCF—leucovorin, gemcitabine, cisplatin, and 5FU.
See this image and copyright information in PMC

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References

    1. Siegel R.L., Miller K.D., Jemal A. Cancer statistics, 2018. CA Cancer J. Clin. 2018;68:7–30. doi: 10.3322/caac.21442. - DOI - PubMed
    1. Shimoda M., Kubota K., Shimizu T., Katoh M. Randomized clinical trial of adjuvant chemotherapy with S-1 versus gemcitabine after pancreatic cancer resection. Br. J. Surg. 2015;102:746–754. doi: 10.1002/bjs.9775. - DOI - PubMed
    1. Kumar J., Reccia I., Sodergren M.H., Kusano T., Zanellato A., Pai M., Spalding D., Zacharoulis D., Habib N. Radiofrequency assisted pancreaticoduodenectomy for palliative surgical resection of locally advanced pancreatic adenocarcinoma. Onco_target. 2018;9:15732–15739. doi: 10.18632/onco_target.24596. - DOI - PMC - PubMed
    1. Jemal A., Bray F., Center M.M., Ferlay J., Ward E., Forman D. Global cancer statistics. CA Cancer J. Clin. 2011;61:69–90. doi: 10.3322/caac.20107. - DOI - PubMed
    1. Ghosn M., Ibrahim T., Assi T., Rassy E.E., Kourie H.R., Kattan J. Dilemma of first line regimens in metastatic pancreatic adenocarcinoma. World J. Gastroenterol. 2016;22:10124–10130. doi: 10.3748/wjg.v22.i46.10124. - DOI - PMC - PubMed

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