Developing effective combination therapy for pancreatic cancer: An overview

Pharmacol Res. 2020 May:155:104740. doi: 10.1016/j.phrs.2020.104740. Epub 2020 Mar 2.

Abstract

Pancreatic cancer is a fatal disease. The five-year survival for patients with all stages of this tumor type is less than 10%, with a majority of patients dying from drug resistant, metastatic disease. Gemcitabine has been a standard of care for the treatment of pancreatic cancer for over 20 years, but as a single agent gemcitabine is not curative. Since the only therapeutic option for the over 80 percent of pancreatic cancer patients ineligible for surgical resection is chemotherapy with or without radiation, the last few decades have seen a significant effort to develop effective therapy for this disease. This review addresses preclinical and clinical efforts to identify agents that target molecular characteristics common to pancreatic tumors and to develop mechanism-based combination approaches to therapy. Some of the most promising combinations include agents that inhibit transcription dependent on BET proteins (BET bromodomain inhibitors) or that inhibit DNA repair mediated by PARP (PARP inhibitors).

Keywords: AZD6738 (PubChem CID: 54761306); BET bromodomain inhibitors; Bevacizumab (PubChem SID: 46504473); Cetuximab (PubChem SID: 46507042); Erlotinib (PubChem CID: 176870); Gemcitabine; Gemcitabine (PubChem CID: 60750); JQ1 (PubChem CID: 49871818); MK-8776 (PubChem CID: 46239015); Nivolumab (PubChem SID: 178103907); Olaparib (PubChem CID: 23725625); PARP inhibitors; Pancreatic cancer; Vorinostat (PubChem CID: 5311).

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Acetylation / drug effects
  • Animals
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • DNA Damage
  • Deoxycytidine / analogs & derivatives
  • Deoxycytidine / therapeutic use
  • Gemcitabine
  • Histones / metabolism
  • Humans
  • Pancreatic Neoplasms / drug therapy*
  • Pancreatic Neoplasms / genetics
  • Pancreatic Neoplasms / metabolism
  • Proteins / antagonists & inhibitors

Substances

  • Antineoplastic Agents
  • Histones
  • Proteins
  • bromodomain and extra-terminal domain protein, human
  • Deoxycytidine
  • Gemcitabine