Abstract

Prevalence of pancreatic cancer (PC) is not high in the population, but the aggressive nature of the disease leads to the fact that PC is one of the main causes of death in a group of patients with cancer. The prognosis for PC is significantly worse in the case of metastatic spread. It is proved that pancreatic adenocarcinoma from the very beginning is a systemic disease with early micrometastatic spread, so the question of effective drug treatment is extremely relevant. Chemotherapy is the basis for the treatment of patients with metastatic prostate cancer. However, despite numerous clinical studies using known cytostatic and targeted agents, progress in the treatment of this disease remains relatively modest compared to the progress made in the treatment of other types of tumors. The complexities of prostate cancer therapy are explained by the presence of a dense connective tissue tumor stroma, which is not just a barrier to tumor cells. It has a significant impact on various vital cellular processes, including tumor formation, invasion, metastasis, and contributes to the formation of drug resistance. Pancreatic cancer is heterogeneous in terms of molecular and biological characteristics. Many genetic changes, including germ lines and somatic mutations, contribute to the development of this disease. Recent studies have shown that each sample of prostate cancer includes an average of 63 genetic changes and 12 major signalling pathways. Further studies of tumor microenvironment markers and decoding the heterogeneity of the tumor genome in PC should become the basis for a “personalized” approach to treatment. It is likely 19 4'2020 ТОм 19 vol. 19 РОССИЙСКИЙ БИОТЕРАПЕВТИЧЕСКИЙ ЖУРНАЛ Russian journal of biotherapy Обзоры литературы that in the future, the integration of traditional chemotherapeutic treatments and an immunological approach will be the key to effective treatment of this deadly disease.

Highlights

  • Prevalence of pancreatic cancer (PC) is not high in the population, but the aggressive nature of the disease leads to the fact that PC is one of the main causes of death in a group of patients with cancer

  • The prognosis for PC is significantly worse in the case of metastatic spread

  • It is proved that pancreatic adenocarcinoma from the very beginning is a systemic disease with early micrometastatic spread, so the ques­ tion of effective drug treatment is extremely relevant

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Summary

Introduction

Стандартом лечения метастатического РПЖ в настоящее время являются 2 режима: FOLFIRINOX и комбинация препаратов Nab-паклитаксел с гемцитабином [14, 18]. Что среди больных, получавших 1‐ю линию терапии в режимах гемцитабин + Nab-паклитаксел и FOLFIRINOX, соответственно 36,1 и 41,3 % смогли получить 2‐ю линию лечения. За последние несколько лет опубликованы обнадеживающие результаты многочисленных клинических испытаний фазы III, которые расширили терапевтические возможности для пациентов с распространенным РПЖ [20,21,22,23].

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