Therapeutic Intervention of Human Pancreatic Cancer

Pancreatic cancer is one of the most lethal malignancies in the world. The incidence of pancreatic cancer keeps on increasing without a significant decrease in mortality. Current therapeutic options are surgical resections, radiation, and chemo, biologic, immune and palliative therapy. Surgical therapies are associated with acceptable outcomes but resected patients suffer from tumor recurrence. The role of post-operative radiotherapy reported increased survival. Currently four chemotherapy drugs approved by the United States Food and Drug Administration (US FDA) for the treatment of pancreatic cancer: ABRAXANE (albumin-bound paclitaxel), gemcitabine, 5-fluorouracil (5- FU) and ONIVYDE (irinotecan liposome injection). Among the conventional chemotherapies the combination of abraxane (nab-paclitaxel) with gemcitabine and FOLFIRINOX (5-FU/leucovorin, irinotecan, oxaliplatin) in metastatic pancreatic cancer patients are promising. Among the targeted therapies the combination of gemcitabine, erlotinib and capecitabine are likely to form the base for future treatment. Under biologic or immunotherapy antibodies against programmed death-1 receptor (PD-1), its ligand PD-L1, cytotoxic T lymphocyte associated antigen-4 (CTLA-4), KRAStargeting vaccines, mucin-1 (MUC1) vaccine, telomerase-targeting vaccine (GV1001), gastrinbased vaccine, dendritic cell (DC)-based vaccine alone or combined with Lymphokine Activated Killer (LAK) cells and allogeneic GM-CSF-secreting vaccine (GVAX) are new therapeutic option for pancreatic cancer. Current and future clinical trials using natural compounds such as deltatocotrienol, Huang-Qin-Tang (HQT) and its botanical formulation (PHY906) and curcumin in combination with other agents are ongoing to discover more effective ways of treating pancreatic cancer patients