Nab-paclitaxel plus gemcitabine in the treatment of metastatic pancreatic cancer: utility and experience from the clinic

Abstract

Pancreatic ductal adenocarcinoma remains one of the deadliest epithelial cancers, primarily due to late diagnosis, early metastasis and the lack of effective treatments. With recent advances in systemic therapies, the median survival for metastatic disease has essentially doubled to approximately 1 year, and a significant number of patients are receiving multiple lines of therapy. One such first-line therapy is the combination of gemcitabine with nab-paclitaxel, which was approved by the US Food and Drug Administration in 2013. This standard option is now serving as a backbone to other novel combinations. In this review, we focus on the development of this combination, its clinical utility, and real-life experiences of managing patients with metastatic pancreatic ductal adenocarcinoma receiving gemcitabine and nab-paclitaxel.

Emerging roles for the IL-6 family of cytokines in pancreatic cancer

“…For the majority of patients, disease will be locally advanced or metastatic, disqualifying them from undergoing potentially curative surgery [1,3]. In these cases, patients are typically offered chemotherapy with palliative intent [10][11][12].…”

“…A current lack of reliable diagnostic markers that would enable early screening [9], coupled with largely non-specific symptoms of disease, results in over 50% of patients presenting with metastatic disease at diagnosis [1,3]. This subgroup of patients have limited therapeutic options, and are thus typically administered palliative chemotherapy aimed at prolonging survival and reducing symptoms during end-of-life care [10][11][12]. Moreover, whilst approximately 10-20% of patients present with localised disease that is eligible for potentially curative surgery [1,12,13], disease recurs in over 70% of patients post-resection [14,15].…”