Effective therapies against metastatic pancreatic cancer remain limited, and
despite treatment, many will ultimately progress. Previously, few options were available
for second line therapy in metastatic pancreatic cancer. Liposomal encapsulated
irinotecan, in combination with leucovorin-modulated fluorouracil, was found to
significantly increase overall survival in patients who have progressed after gemcitabine-
based therapy in a large, international, randomized clinical trial (NAPOLI-1).
We reviewed the background of systemic therapy for metastatic pancreatic cancer,
examined putative mechanisms for the success of encapsulated drugs, and identified
recent patent applications on the use of liposomal irinotecan in pancreatic cancer. The
landmark NAPOLI-1 trial established a second-line option for those with metastatic
pancreatic cancer refractory to gemcitabine chemotherapy, but effective therapies with long duration of
response are still lacking. Alternative techniques targeting key driver genes in pancreatic cancer and novel
methods of early detection and targeting drugs are currently being explored. How liposomal irinotecan
can be integrated into chemotherapy regimens, including neoadjuvant or first line combinations, are
currently being tested in clinical trials and covered by several new patent applications.
Keywords: Liposomal irinotecan, MM-398, Nal-IRI, NAPOLI-1, pancreatic cancer, refractory cancer.
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