Pancreatic cancer, with less than 1% of 5 year survival rate, is one of the most highly malignant tumors.
The classic drug used to treat breast cancer, gemcitabine (GEM), was proved to improve the life quality and survival in advanced pancreatic cancer patients. As early as 1996, the U.S. Food and Drug Administration (FDA) had approved GEM for the treatment of advanced pancreatic cancer. This made GEM became the standard first-line drug, replacing the previous 5-fluorouracil (5-Fu). In addition, the pancreatic cancer patients carry BRCA or PALB2 genetic mutation may be more sensitive to platinum-based drugs. Therefore, in the 2012 edition of the National Comprehensive Cancer Network (NCCN) guidelines, GEM combined with PDD has been recommended for the treatment of pancreatic cancer, especially in patients with a family history.
Nowadays, with the development of molecular biology, molecular targeted related drugs have been a hot topic in the treatment of pancreatic cancer. EGFR is overexpressed in pancreatic cancer and related with the highly invasive, rapid progress and poor prognosis of tumor. Currently, there are two major categories for EGFR-targeted drugs: one is a macromolecules monoclonal antibody (eg: cetuximab, etc.) which act on the extracellular domain of EGFR and inhibit EGFR ligands through combination with EGFR; the other is a small molecule tyrosine kinase inhibitor (EGFR-TKI, such as gefitinib and erlotinib, etc.), can enter the cell and directly act on the intracellular region of EGFR, thereby inhibiting the tyrosine kinase activity.
Currently, even the drug for treatment advanced pancreatic cancer has been progress, but the overall efficacy and safety is far from satisfactory. The mainly survival time has not been fundamentally improved. Therefore, the development of pancreatic cancer drugs is still a long way to go process.