Targeted therapies for pancreatic cancer.

The prognosis of patients with pancreatic cancer is extremely poor, and current systemic therapies provide marginal survival benefits for treated patients. The era of targeted therapies has offered a new avenue to search for potentially more effective strategies. Findings from phase III studies of molecular agents targeting vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) were disappointing, although results with the EGFR tyrosine kinase inhibitor erlotinib were statistically significant but clinically of marginal benefit. Ongoing trials are assessing other single targeted agents and combinations of targeted therapies combined with gemcitabine in an effort to treat the multiple molecular pathways that seem to be active in this disease. Better preclinical modeling, improved clinical trial designs with adequate pilot studies, and better patient selection in trials of interventions are needed to improve the yield from research efforts.