Intra-arterial regional chemotherapy for pancreatic cancer (review)

Abstract

Pancreatic cancer, despite its low prevalence, is the fourth most common cause of cancer death, with a 5-year survival rate of no more than 10 %. Experts predict that by 2030, pancreatic cancer will become the second most common cause of death from malignant neoplasms, surpassing colorectal and breast cancers. Thus, pancreatic cancer is characterized by very unfavorable prognosis, primarily due to the chemoresistant nature of the tumor.Only a few treatment options for pancreatic cancer are currently available, with low response rates, short progression-free survival and short overall survival, and severe toxicity. In order to improve clinical outcomes, a number of studies on the use of regional chemotherapy as a treatment option for pancreatic cancer have demonstrated dose-dependent tumor sensitivity. Chemotherapy by intra-arterial perfusion of the pancreas made it possible to increase local concentrations of chemotherapeutic agents with minimal effect on healthy tissues and a lower incidence of side effects compared to systemic chemotherapy. This therapeutic approach has demonstrated a good therapeutic effect in the treatment of malignant neoplasms of other localizations. This review summarizes clinical approaches to chemotherapeutic administration by intra-pancreatic intra-arterial perfusion in terms of methods, pharmacokinetics, and clinical outcomes.