Therapeutic tools in pancreatic cancer

Pancreatic cancer is the fourth leading cause of cancer death in the United States and has a lower survival rate than other digestive tract tumors. It remains a therapeutic challenge with limited active agents. Honing our current understanding of markers of toxicity and response, and individualizing treatment with the prognostic and therapeutic tools available are important to make a worthy impact on a patient's course. The authors summarize selected abstracts from the ASCO Gastrointestinal Cancers Symposium, San Francisco, CA, USA, January 15-17, 2009. The Symposium featured pancreatic cancer in 84 research abstracts, of which, seven are reviewed that focus on markers of toxicity: cytidine deaminase (Abstract #151) and haptogloin (Abstract #167) as markers of gemcitabine toxicity; markers of response: use of PET scan for prognosis (Abstract #157), and correlations with CA 19-9 to post-chemo-radiation resectability (Abstract #215) and time to progression (Abstract #160); and individualized applications: characterizing the phenotypic similarities between a patient tumor and the direct xenograft (Abstract #154) and a report about the poor outcome of patients with ascites (Abstract #220). Validated clinical tools that can assist in managing patients through the narrow therapeutic window are needed.