Systemic chemotherapy for pancreatic cancer.

Surgical resection offers the only curative strategy for pancreatic cancer. Yet, because early detection of pancreatic cancer is so difficult and diagnosis is delayed, pancreatic cancer in most patients is surgically unresectable. Even in patients with resectable disease, the long-term outcome remains unsatisfactory due to early recurrence after resection. Early appearance of distant metastasis suggests that systemic treatment, such as chemotherapy, should play a major role in improving patient survival. Although the recently developed gemcitabine has renewed interest in clinical research for pancreatic cancer, other currently available chemotherapeutic agents have little impact on survival. Studies to identify more effective agents or treatment regimens must have the highest priority. The expanding understanding of molecular and genetic biology should facilitate research to develop novel molecule-targeted agents and to establish individualized therapy regimens for this disease.