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Tanios Bekaii-Saab, Richard Goldberg, Therapeutic Advances in Pancreatic Cancer: Miles to Go Before We Sleep, JNCI: Journal of the National Cancer Institute, Volume 107, Issue 2, February 2015, dju439, https://doi.org/10.1093/jnci/dju439
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Pancreas adenocarcinoma maintains its dastardly reputation as among the most lethal of cancers ( 1 ). Following decades of negative studies, new drug combinations are shifting the treatment landscape for this disease. In 2010, the Actions Concertées dans les Cancer Colo-Rectaux et Digestif (ACCORD) 11 study known as Partenariat de Recherche en Oncologie Digestive (PRODIGE) 4 found Oxaliplatin; Irinotecan; Leucovorin; and Flourouracil (FOLFIRINOX) statistically improved response rate (RR), progression-free survival (PFS), and overall survival (OS) over single-agent gemcitabine ( 2 ). Shortly thereafter, Van Hoff et al. published the Metastatic Pancreatic Adenocarcinoma Clinical Trial (MPACT) phase III study; combining nab -paclitaxel with gemcitabine statistically improved RR, PFS, and OS compared with gemcitabine alone ( 3 ). More recently, a three-arm phase III study, NAPOLI-1, comparing single agent MM398 (nanoliposomal irinotecan), infusional 5-fluorouracil (5FU), and MM398 plus infusional 5FU (MMF) found improved outcomes with the combination in patients with refractory metastatic pancreatic cancer ( 4 ). Charité Onkologie (CONKO)-003, confirmed that OFF (oxaliplatin, folinic acid and fluorouracil) was superior to 5FU in patients with refractory metastatic pancreatic cancer ( 5 ).