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Emerging Therapeutic Targets in Pancreatic Adenocarcinoma

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Pancreatic Cancer

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Abstract

Pancreatic adenocarcinoma is one of the most lethal cancers but has limited therapeutic options necessitating continued investigation of new therapeutic agents. Recently, improved overall survival has been achieved with cytotoxic drug combinations including 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) and gemcitabine/nab-paclitaxel, but the success has been modest at best. More targeted approaches focusing on EGFR and MAPK signaling have also enjoyed marginal success. Accumulating evidence suggests that pancreatic tumors have increased dependence on metabolic pathways through both KRAS and KRAS-independent mechanisms and are broadly resistant to drug therapy due to stromal remodeling. Genetic and epigenetic vulnerabilities, such as inactivating aberrations in DNA damage repair, chromatin remodeling, and microRNA dysregulation, may reveal exploitable weaknesses. Modern approaches to drug development tailored to molecularly defined subsets of patients likely to respond to targeted therapies are needed to achieve more substantial progress in this disease in an era of precision medicine.

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Authors and Affiliations

  1. Division of Medical Oncology, Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA

    Jennifer H. Choe & James L. Abbruzzese

Authors
  1. Jennifer H. Choe
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  2. James L. Abbruzzese
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Correspondence to Jennifer H. Choe .

Editor information

Editors and Affiliations

  1. DMCCMC, University of Liverpool DMCCMC, Liverpool, United Kingdom

    John P. Neoptolemos

  2. Rochester, Minnesota, USA

    Raul Urrutia

  3. Dept. Gastrointestinal Medical Onco, Duke University Medical Center Dept. Gastrointestinal Medical Onco, Durham, North Carolina, USA

    James Abbruzzese

  4. Heidelberg, Germany

    Markus W. Büchler

Section Editor information

  1. Division of Surgery and Oncology, University of Liverpool, Daulby Street, Liverpool, UK

    John Neoptolemos

  2. Mayo Clinic Cancer Center, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA

    Raul A. Urrutia

  3. Duke University Medical Center, Durham, NC, USA

    James L. Abbruzzese

  4. Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    Markus W. Büchler MD

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Choe, J.H., Abbruzzese, J.L. (2016). Emerging Therapeutic Targets in Pancreatic Adenocarcinoma. In: Neoptolemos, J., Urrutia, R., Abbruzzese, J., Büchler, M. (eds) Pancreatic Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-6631-8_92-1

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  • DOI: https://doi.org/10.1007/978-1-4939-6631-8_92-1

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  • Print ISBN: 978-1-4939-6631-8

  • Online ISBN: 978-1-4939-6631-8

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