Progress of medical treatment of advanced pancreatic carcinoma

doi:10.19538/j.cjps.issn1005-2208.2017.07.11

Abstract：Most patients of pancreatic carcinoma are local advanced or distant metastasis occurred when diagnosed,and they don't have the chance to operate,with a poorer diagnosis. Positive internal medical treatment could prolong the overall survival time,and promote quality of life and improve the patients' life status. At present,the major therapy for advanced pancreatic cancer is gemcitabine-based combination treatment. For patients with a better ECOG performance status, the first line therapy could select FOLFIRINOX, gemcitabine combined nab-paclitaxel, gemcitabine combined fluorouracil,etc. For patients with worse ECOG performance status,single medication such as gemcitabine or fluorouracil. For patients with specific targeted genes,chemotherapy and targeted therapy could be combined,such as gemcitabine combined with erlotinib. The second line therapy is based on the first line therapy selection. Nanoliposomal irinotecan, gemcitabine, fluorouracil and irinotecan are now recommended. In the future,the treatment of pancreatic carcinoma should be based on the translational medicine,regarded the pancreatic cancer patients as a whole, focusing on microenvironment and immunological regulation. New treatments appliance and new targeted therapy should be explored,and clinical trials are strongly recommended. The final aim is to realize personal precision treatment instead of traditional diagnostic procedure.