[Pancreatic adenocarcinoma: therapeutical update]

Cancer of the exocrine pancreas continues to be a major unsolved health problem. Because of difficulties in diagnosis, the aggressiveness of pancreatic cancers, and the lack of effective systemic therapies, generally fewer than 5% of patients with adenocarcinoma of the pancreas survive 5 years after diagnosis. Thus, incidence rates and mortality rates are virtually identical. The median survival in metastatic pancreatic cancer is nearly six months.Today, surgery remains the only curative therapeutic option, and the standard treatment in patients with advanced disease is gemcitabine. New strategies for resectable and unresectable pancreatic cancer are under active investigation,such as neoadjuvant or adjuvant chemoradiotherapy or combinations of gemcitabine with new cytotoxic agents (oxaliplatin, cetuximab, gefitinib, bevacizumab) with promising results. In patients with locally advanced pancreatic cancer and good performance status, chemoradiotherapy should be considered.