Targeted treatment of pancreas carcinoma - past or future?

Abstract

Pancreas carcinoma is a disease with an increasing occurrence and a devastating prognosis. The main cause of the unfavourable prognosis is late diagnosis which most frequently occurs in the state of generalisation and resistance to the currently used chemotherapy. The currently used chemotherapeutical regimes have a non-specific impact on carcinoma; they are administered with a palliative effect and lead only to a marginal improvement in the survival rate. The lack of a curable treatment means that less than 5% of patients survive five years. The targeted treatment aims to find signal paths, which are only active in the carcinoma and entirely necessary for its occurrence or progression. Progress in our understanding of molecular and biological processes characterising pancreas carcinoma and success in the targeted treatment of other tumour diseases led to an effort to find a targeted treatment for pancreas carcinoma. During the last decade a number of targeted chemotherapeutics were tested. However, their clinical significance has so far been only limited and we are still waiting for an effective targeted treatment. Closer understanding of molecular mechanisms of pathogenesis and identification of new suitable goals and molecules for inhibition in selected patients represent the highest potential for the future treatment of pancreas carcinoma.