New Chemotherapeutic Advances in Pancreatic, Colorectal, and Gastric Cancers

Abstract

Abstract Learning Objectives After completing this course, the reader will be able to: Explain the need for more effective chemotherapy regimens for the treatment of advanced pancreatic, gastric, and colorectal cancer. Select the most appropriate treatment regimen in each of these categories based on the best available evidence. Identify the many new agents that target novel molecules in these cancers that are being explored in combination with conventional chemotherapy regimens. Access and take the CME test online and receive 1 hour of AMA PRA category 1 credit at CME.TheOncologist.com Pancreatic, gastric, and colorectal cancers are major causes of morbidity and mortality worldwide. When curative surgical resection is not an option, these malignancies tend to respond very poorly to chemotherapy and carry a dismal prognosis. There is, therefore, an urgent need for novel treatment strategies for these cancers. Great strides have been made in colon cancer treatment with the recent introduction of several novel agents, including capecitabine, irinotecan, and oxaliplatin either alone or in combination regimens. Treatment of advanced colon cancer, however, remains essentially palliative, and treatment-related toxicity remains a significant problem. The treatment of advanced gastric and pancreatic cancer has also seen the introduction of new agents, such as gemcitabine and irinotecan; however, the impact of these agents on survival has been small, and toxicity continues to be a major obstacle. The search for new chemotherapeutic agents and treatment strategies will need to focus on improving outcomes and safety and tolerability profiles. To date, several new agents have shown promise, including pemetrexed, G17DT, bevacizumab, and other targeted agents. Further research into their optimal use either alone or in combination regimens should be a priority.