Therapy of metastasized pancreatic carcinoma [Therapie des metastasierten Pankreaskarzinoms]

Background: Pancreatic ductal adenocarcinoma (PDAC) is a relatively frequent cause of tumor-related death in western industrialized nations. Due to a lack of specific early symptoms primary diagnosis is commonly delayed so that approximately 80 % of newly diagnosed patients are already in a non-resectable, locally advanced or even metastatic tumor setting. For these patients palliative systemic therapy is usually the only treatment option. Objectives and methods: This article provides an overview of the established and new treatment options for patients with metastatic pancreatic cancer as well as new study results and therapy concepts, the impact on the routine therapeutic decisions and the outlook for future developments. Results: In recent years the therapeutic options for metastatic PDAC have made clear progress by the introduction of new treatment regimens (e.g. FOLFIRINOX) or new substances (e.g. nab-paclitaxel) that have proven to be superior to the previous standard of care in first line therapy, gemcitabine. In addition, the evidence in the field of second line therapy is improving and new promising therapeutic approaches in the field of targeted therapies and immunotherapy are emerging. © 2015, Springer-Verlag Berlin Heidelberg.