Treatment of pancreatic cancer: current limitations, future possibilities.

In an attempt to improve the grave prognosis associated with the diagnosis of pancreatic cancer, researchers have explored a number of novel therapies. These include hormonal therapy, immunotherapy, radiopharmaceuticals, and novel chemotherapeutic agents. Unfortunately, most of these efforts have led at best to modest improvements in median survival, and have provided little opportunity for cure. Recent advances at the molecular level may provide an alternative approach to the management of pancreatic cancer. The majority of pancreatic cancers possess K-ras mutations. K-ras proteins are small (21-kd) proteins that normally serve as guanosine triphosphate (GTP)-regulated switches to control a diverse array of cellular signals that modulate highly regulated programs of proliferation, differentiation, and death. Newer therapies aimed at modifying the ras signal transduction pathways may provide avenues for future clinical investigation.