Emerging Systemic Therapy Considerations for Pancreatic Cancer

Pancreatic ductal adenocarcinoma (PDAC) is anticipated to be the second leading cause of cancer-related death in the United States by 2030. For the majority of patients who are diagnosed with de novo metastatic disease, 5-year overall survival remains dismal at less than 10%. Until recently, PDAC has been considered as a monolithic entity with limited treatment options. With advances in genomic profiling, targeted therapies, and immune-based strategies, a number of emerging biomarker-driven treatment modalities have begun to enter into clinical practice. In this review, we describe the historical perspective of systemic PDAC treatments in the advanced setting, as well as the emerging treatments which leverage genomic heterogeneity and synergistic mechanisms of action.