Current status of chemoradiotherapy for locally advanced pancreatic cancer in Japan

Abstract

Although the results of randomized controlled trials for locally advanced pancreatic cancer conducted between 1969 and 1988 demonstrated a survival advantage for concurrent radiotherapy and bolus 5-fluorouracil (FU) injection, the prognosis of patients with this disease remains very poor. In an attempt to improve patient outcome after chemoradiotherapy, various clinical trials for this disease have been conducted in Japan. These trials were designed to evaluate novel chemotherapy regimens combined with conventional radiotherapy, or intensive radiotherapy in combination with chemotherapy. After gemictabine was shown to yield a better survival outcome than 5-FU in patients with advanced disease, this drug was investigated as a chemotherapeutic agent and/or radiosensitizer for locally advanced pancreatic cancer in a number of trials. S-1, a novel oral fluoropyrimidine derivative that appears promising for the treatment of metastatic disease, is also being intensively evaluated in Japan for the treatment of locally advanced pancreatic cancer. In this review, we summarize recent treatment strategies that are being used in Japan with the goal of establishing a new standard therapy for locally advanced pancreatic cancer.

Antitumor effects of α‐bisabolol against pancreatic cancer

“…Even in patients with resectable disease, the long-term outcome remains unsatisfactory because of early recurrence after resection. (34) Therefore, alternative treatments are required to improve the prognosis of patients with pancreatic cancer.…”

A phase II study of oral S‐1 with concurrent radiotherapy followed by chemotherapy with S‐1 alone for locally advanced pancreatic cancer

“…Concomitant radiotherapy and chemotherapy is commonly used to treat locally unresectable pancreatic cancers [8]. S‐1 is expected to improve the outcomes of chemoradiotherapy for locally advanced pancreatic cancer because of its high palliative effectiveness, as well as its potent radiosensitizer activity . The preliminary results of a Japanese phase II study of S‐1 in patients with advanced pancreatic cancer demonstrated high safety and effectiveness [16, 17].…”

Aberrant glycogen synthase kinase 3β in the development of pancreatic cancer

“…[1–389] Radiation therapy alone or in combination with gemcitabine-based chemotherapy has a role in the treatment of locally advanced pancreatic cancer (eg, stage III), whereas its role in stage IV (metastatic) disease is palliative. [129091] Radiation therapy as pre- or post-operative treatment invokes controversy, and these are areas under study. Two groups of investigators proposed a new combination chemotherapeutic regimen, FOLFIRINOX (leucovorin, 5-fluorouracil, irinotecan, and oxaliplatin), and tested its effects on metastatic pancreatic cancer compared to gemcitabine.…”