Immunotherapy for Pancreatic Cancer

Abstract

Patients with pancreatic cancer have an especially poor prognosis, with a 5-year survival rate of <1% and a median survival of 4-6 months (Jemal, Siegel et al., 2010). The management of patients with pancreatic cancer depends on the extent of the disease at diagnosis. However, approximately 80% of patients present with advanced-stage disease that precludes surgical resection (pancreaticoduodenectomy) and long-term survival is poor (Sener, Fremgen et al., 1999). Even after resection, the majority of patients relapse, leading to a median survival of about 18 months after resection (Neoptolemos, Stocken et al., 2004). In this time, gemcitabine-based chemotherapy is typically offered as standard of care. However, most patients treated with gemcitabine alone do not survive longer than 6 months, as the tumor cells are naturally resistant to current chemotherapy (Neoptolemos, Stocken et al., 2004). Importantly, the tumors that develop gemcitabine resistance would still be a suitable target for immunotherapy. Therefore, cancer immunotherapy for pancreatic cancer may be one attractive approach to treatment. This chapter summarizes the effect of immunotherapy for inducing cytotoxic T lymphocytes (CTLs) in patients with pancreatic cancer and discusses recent advances in concept of combination therapy of immunotherapy and chemotherapy.