INTRA-ARTERIAL CHEMOTHERAPY IN ADVANCED PANCREATIC CANCER: A LITERATURE REVIEW.

Abstract

Pancreatic cancer is an extremely aggressive malignancy with a 5-year survival rate among all stages of about 7%. Treatment options for unresectable forms are limited to fluoropyrimidine- and gemcitabine-containing regimens, and starting from the 3rd line, international guidelines do not provide clear recommendations because of the poor clinical condition of patients and the low efficacy of the consecutive lines. The arterial infusion is a promising method of treatment for locally advanced or liver-only metastatic disease, providing a higher local concentration with the same or lower systemic toxicity. The most often used intra-arterial regimens are those based on 5-fluorouracil and gemcitabine. This method was found to be superior in overall survival, response rate, and control of local symptoms compared to control groups treated with systemic chemotherapy. The approach has a good safety profile and is well tolerated. The method is promising for patients with an adequate performance status, who have run out of other potential regimens, in cases without distant metastases or liver-only metastatic disease, and for upcoming clinical trials or studies.