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World J Gastrointest Oncol. Mar 15, 2016; 8(3): 297-304
Published online Mar 15, 2016. doi: 10.4251/wjgo.v8.i3.297
Is metastatic pancreatic cancer an untargetable malignancy?
Hampig Raphael Kourie, Joseph Gharios, Fadi Elkarak, Joelle Antoun, Marwan Ghosn
Hampig Raphael Kourie, Joseph Gharios, Fadi Elkarak, Joelle Antoun, Marwan Ghosn, Department of Oncology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
Author contributions: Kourie HR and Ghosn M initiated the review; Kourie HR, Gharios J and Ghosn M performed the review, wrote and analyzed the data; Kourie HR, Gharios J, Elkarak F, Antoun J and Ghosn M reviewed the paper.
Conflict-of-interest statement: Authors confirm that they do not have any conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Marwan Ghosn, MD, Department of Oncology, Faculty of Medicine, Saint Joseph University, Monot St, PO Box 166830, Beirut, Lebanon. marwanghonmd@yahoo.com
Telephone: +961-1-3226842 Fax: +961-1-1613397
Received: June 29, 2015
Peer-review started: July 2, 2015
First decision: September 22, 2015
Revised: November 9, 2015
Accepted: December 18, 2015
Article in press: December 21, 2015
Published online: March 15, 2016
Abstract

Metastatic pancreatic cancer (MPC) is one of the most aggressive malignancies, known to be chemo-resistant and have been recently considered resistant to some targeted therapies (TT). Erlotinib combined to gemcitabine is the only targeted therapy that showed an overall survival benefit in MPC. New targets and therapeutic approaches, based on new-TT, are actually being evaluated in MPC going from immunotherapy, epigenetics, tumor suppressor gene and oncogenes to stromal matrix regulators. We aim in this paper to present the major causes rendering MPC an untargetable malignancy and to focus on the new therapeutic modalities based on TT in MPC.

Keywords: Pancreatic cancer, Tumor suppressor genes, Targeted therapies, Immunotherapy, Epigenetics

Core tip: This paper will report on the most recent updates in the treatment of metastatic pancreatic cancer (MPC). We present the major causes rendering MPC an untargetable malignancy and we focus on the new therapeutic modalities based on targeted therapies in MPC.