Emerging treatments for advanced pancreatic cancer: clinical potential of albumin-bound paclitaxel

Abstract:

The management of pancreatic cancer has historically represented a major challenge for oncologists. The inherent aggressiveness of this tumor and the fibrotic features of the surrounding stromal tissue have significantly limited the impact of standard chemotherapy. Moreover, the paucity of available tumor tissue has hampered a better understanding of the biology of this disease as well as the development of new treatment strategies. Recently, the therapeutic landscape of metastatic pancreatic cancer has been enriched by two new combination regimens (FOLFIRINOX and gemcitabine-nab-paclitaxel) which have been demonstrated to improve the outcome in patients with good performance status. Moreover, the peritumoral stroma has been increasingly recognized as a potential therapeutic target for this disease, and several new agents targeting stromal components are currently under investigation. In this paper, we review the current treatment options for advanced pancreatic cancer, highlight the role of the peritumoral stroma, and discuss the clinical potential of nab-paclitaxel and antistromal treatment strategies.

Keywords::

• pancreatic cancer
• nab-paclitaxel
• stroma
• SPARC

Acknowledgments

We acknowledge support from the National Institute for Health Research Biomedical Research Centre at the Royal Marsden Hospital and Institute of Cancer Research and from the Peter Stebbings Memorial Charity.

Disclosure

David Cunningham has received research funding from Amgen, Roche, Sanofi-Aventis, Merck-Serono. The authors report no other of interest in this work.