Masitinib plus gemcitabine for personalized treatment of PDAC patients with overexpression of ACOX1

Abstract

ABSTRACTIntroduction: Although advances in diagnosis, surgery and systemic therapy pancreatic ductal adenocarcinoma (PDAC) patients have still bad prognosis. In contrast to the progress in early diagnosis and results of the treatment of other cancers the PDAC patients outcomes do not change significantly over the years.Areas covered: The main objective of this paper was to search for new treatment and research opportunities for PDAC patients, the second an attempt to understand the reasons for bad PDAC patients treatment results (chemoresistance?) and why there was so many negative trials is this setting. As a consequence we search for new targets which blockade may lead to achieve better patients outcomes.Expert commentary: We found that ACOX1 overexpression plays an important role in cancer development. PDAC patients with ACOX1 overexpression have poor prognosis when treated with gemcitabine monotherapy. Treatment with masitinib in combination with gemcitabine significantly improves outcome of PDAC patients with ACOX1 overexpression with median overall survival (OS) of 11.7 months in comparison to median OS of 5.6 months in patients treated with gemcitabine in monotherapy, p<0.001, HR = 0.23. As these studies have many limitation, mainly due to small patients sample, confirmatory study is needed.