Pancreatic cancer MEK inhibitors for KRAS+ and second line therapy- pro
J.R. Infante et al, A Randomised, Double-Blind, Placebo-Controlled Trial of Trametinib, an Oral MEK Inhibitor, in Combination With Gemcitabine for Patients With Untreated Metastatic Adenocarcinoma of the Pancreas. Eur J Cancer . 2014 Aug;50(12):2072-81
Chao, M., Chang, L., Tu, H. et al. Combination treatment strategy for pancreatic cancer involving the novel HDAC inhibitor MPT0E028 with a MEK inhibitor beyond K-Ras status. Clin Epigenet 11, 85 (2019).
A recent study by Infante et al suggested that pre-clinical suggestions that KRAS renders sensitivity to MEL inhibiting drugs, may nto be correct. he addition of trametinib to gemcitabine did not improve OS, PFS, ORR or DOR in patients with previously untreated metastatic pancreas cancer. Outcomes were independent of KRAS mutations determined by cfDNA. More studies need to be done.
For pancreatic cancer 2nd line therapy, NCCN recommends palliative care, MSI/MMR therapy, if possible, single-agent chemotherapy or palliative RT