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Assessment of Resistance to Tyrosine Kinase Inhibitors by an Interrogation of Signal Transduction Pathways by Antibody Arrays
Published on: September 19, 2018
Small molecule tyrosine kinase inhibitors in pancreatic cancer
Sachin Gupta1, Bassel F El-Rayes
1Department of Hematology/Oncology, Karmanos Cancer Institute, Wayne State University, MI, USA.
Abstract:
Pancreatic cancer has proven to be chemo-resistant, with gemcitabine being the only cytotoxic agent approved for advanced pancreatic cancer since 1996. Tyrosine kinase inhibitors represent a newer generation of chemotherapeutic agents targeting specific tumor pathways associated with carcinogenesis including cell cycle control, signal transduction, apoptosis and angiogenesis. These agents present a more selective way of treating pancreatic cancer. Erlotinib is the prototype of the tyrosine kinase inhibitors with proven efficacy in advanced pancreatic cancer and has been recently approved in that setting. Multiple other tyrosine kinase inhibitors targeting the VEGFR, PDGFR, and Src kinases are in various phases of clinical trials testing. The preliminary results of these trials have been disappointing. Current challenges in pancreatic cancer clinical trials testing include improving patient selection, identifying effective combinations, improving the predictive value of current preclinical models and better study designs. This review summarizes the present clinical development of tyrosine kinase inhibitors in pancreatic cancer and strategies for future drug development.
Insights
Pancreatic cancer remains chemo-resistant, but tyrosine kinase inhibitors offer targeted therapies. While early trials show disappointment, future strategies focus on improved patient selection and study designs for better outcomes.
Area of Science:
- Oncology
- Molecular Biology
- Drug Development
Background:
- Pancreatic cancer exhibits significant chemo-resistance, with gemcitabine as the sole approved agent since 1996.
- Tyrosine kinase inhibitors (TKIs) represent a novel class of targeted therapies for cancer, including pancreatic cancer.
Purpose of the Study:
- To review the clinical development of TKIs in pancreatic cancer.
- To discuss strategies for future TKI drug development in this disease.
Main Methods:
- Review of current clinical trials and literature on tyrosine kinase inhibitors in pancreatic cancer.
- Analysis of challenges in pancreatic cancer clinical trial design and patient selection.
Main Results:
- Erlotinib, a prototype TKI, has shown efficacy and gained approval for advanced pancreatic cancer.
- Other TKIs targeting VEGFR, PDGFR, and Src kinases have yielded disappointing preliminary results in clinical trials.
Conclusions:
- Despite challenges, TKIs offer a more selective approach to pancreatic cancer treatment.
- Future research must focus on improved patient stratification, combination therapies, and enhanced preclinical models for successful TKI development.
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