Prognostic and predictive factors in pancreatic cancer
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Emanuela Dell’Aquila1, Claudia Angela Maria Fulgenzi1, Alessandro Minelli1, Fabrizio Citarella1, Marco Stellato1, Francesco Pantano1, Marco Russano1, Maria Concetta Cursano1, Andrea Napolitano1, Tea Zeppola1, Bruno Vincenzi1, Giuseppe Tonini1 and Daniele Santini1
1 Department of Medical Oncology, University Campus Bio-Medico, Rome 00128, Italy
Keywords: metastatic pancreatic cancer; predictive and prognostic factors; CA19-9; gemcitabine-abraxane; FOLFIRINOX
Received: January 19, 2020 Accepted: February 17, 2020 Published: March 10, 2020
Pancreatic cancer is one of the leading causes of cancer death worldwide. Its high mortality rate has remained unchanged for years. Radiotherapy and surgery are considered standard treatments in early and locally advanced stages. Chemotherapy is the only option for metastatic patients. Two treatment regimens, i. e. the association of 5-fluorouracil- irinotecan-oxaliplatin (FOLFIRINOX) and the association of nab-paclitaxel with gemcitabine, have been shown to improve outcomes for metastatic pancreatic adenocarcinoma patients. However, there are not standardized predictive biomarkers able to identify patients who benefit most from treatments. CA19-9 is the most studied prognostic biomarker, its predictive role remains unclear. Other clinical, histological and molecular biomarkers are emerging in prognostic and predictive settings. The aim of this review is to provide an overview of prognostic and predictive markers used in clinical practice and to explore the most promising fields of research in terms of treatment selection and tailored therapy in pancreatic cancer.
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