Journal: Journal of gastroenterology and hepatology
This publication is a narrative review of current and emerging systemic treatments for advanced pancreatic cancer, with a focus on biomarker-driven and precision approaches.
It first outlines existing first-line standards of care, then concentrates on how homologous recombination deficiency (HRD) is being leveraged for personalized treatment selection. The authors describe how routine tumor next-generation sequencing is increasingly used to identify actionable alterations and guide targeted therapy.
Key highlighted areas include:
- Tumor-agnostic targets: NRG1 fusions and BRAF alterations in KRAS wild-type tumors.
- Rapid development of novel agents: KRAS inhibitors, PROTAC-based strategies, tumor treating fields, and PRMT5 inhibitors for MTAP-deleted tumors.
- Emerging immunotherapeutic approaches: Treatments directed at Claudin18.2 and CXCR4 as potential ways to overcome resistance.
Overall, the paper emphasizes molecular stratification, synthetic lethality, and new target classes as key avenues to expand treatment options and ultimately improve survival in advanced pancreatic cancer.