Treatment of metastatic pancreatic adenocarcinoma: a comprehensive review

Non-toxic and short treatment with gemcitabine inhibits in vitro migration of HT-1080 cells

Gemcitabine has demonstrated clinical activity in solid tumors. Several in vitro studies were carried out regarding its metabolism, toxicity and cell cycle effects, but none was done on the anti-metastasis potential of the drug. We sought to determine the effect of gemcitabine concentrations on migration velocity of HT-1080 cells at concentrations which do not alter cell cycle progression and proliferation. Cells were treated for 1 or 5 h at IC10-70 of gemcitabine in order to estimate its effects on viability, proliferation and migration capacity using flow cytometry and microscopy imaging, respectively. The gemcitabine treatment for 1 h had no effect on cell proliferation, viability, cycle or migration on HT-1080 cells. Even though the 5 h of exposure at IC10, IC20 and IC50 concentrations did not affect cell viability, proliferation and cell cycle repartition, the mean velocity of HT-1080 dramatically decreased by 50 and 30%, respectively. Gemcitabine at IC70 concentrations for 5 h of exposure first induced a time course inhibition of proliferation, together with a decrease in viability and altered cell morphology, and then inhibited cell migration by 50%. These data suggest the possibility to couple the anti-migratory property of gemcitabine with the known anti-tumoral effect in the treatment of tumors with high metastatic potential.

Exploiting molecular targets in pancreatic cancer

Oncology has entered an era of molecular therapy. Given the multitude of molecular defects involved with pancreatic carcinogenesis, invasion, and metastasis, it is unlikely that single-agent targeted therapy will alter the course of this disease. Given the emergence of molecular targets and a growing number of agents available for clinical development, however, meaningful improvements in patient outcomes are expected, particularly if treatments are designed and delivered rationally.