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Adenocarcinoma of the pancreas is a devastating disease with a dismal prognosis. Recent data by the American Cancer Society showed that the 5-year survival rate of patients with pancreatic carcinoma remains at 5% which makes it the most deadly form of cancer known.1 These figures are primarily due to the fact that most tumours are diagnosed at a stage where surgical treatment is no longer possible as the tumour is already in a locally advanced or even metastasised stage. All efforts to provide a systemic therapy to patients with advanced disease have failed. The only approved treatments consist of the nucleosid anlogon gemzitabine and the tyrosine kinase inhibitor erlotinib. However, even combinations of these drugs have no major impact on the survival of patients with pancreatic carcinoma.
Why is this tumour so chemoresistant and how can we overcome this obstacle to improve treatment responses? Several biological features might contribute to the resistance towards systemic treatments. First, ductal carcinomas of the pancreas are genetically highly unstable tumours.2 Recent analysis of pancreatic cancers revealed a multitude of genetic alterations which affected a dozen different …