Published online Jun 9, 2015. doi: 10.5497/wjp.v4.i2.180
Peer-review started: December 2, 2014
First decision: February 7, 2015
Revised: March 9, 2015
Accepted: April 10, 2015
Article in press: April 14, 2015
Published online: June 9, 2015
Core tip: Pancreatic ductal adenocarcinoma is a cancer with several significant genetic aberrations that have recently been identified by international research efforts. Despite these findings, standard therapy for advanced disease consists primarily of chemotherapy. In the last few years two new chemotherapy regimens, FOLFIRINOX and Gemcitabine/Nab-paclitaxel, have demonstrated survival benefits in large phase III trials resulting in a change to current practise. However, the advent of targeted treatments has not yet had a significant impact in this disease compared with other malignancies. Current research strategies include developing therapies directed towards the RAS-RAK-MEK pathway, PI3K-AKT-mTOR pathway, notch pathway and immunotherapies to name but a few, with several clinical trials underway. It is likely that the heterogeneous nature of pancreatic cancer necessitates a more personalised approach to management with targeted treatment guided by predictive biomarkers.