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Multidisciplinary combination strategies integrating modified chemotherapy, radical resection, and intestine auto-transplantation may offer the best available care for locally advanced pancreatic cancer.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/combination-therapies-for-cancer-challenges-and-opportunities/378835/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/combination-therapies-for-cancer-challenges-and-opportunities/378835.png","ImageObject",300,407,{"name":42,"@type":43},"Ezra","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-29","2026-09-24",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",8,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Why is pancreatic cancer considered especially challenging among gastrointestinal cancers?","Question",{"text":63,"@type":64},"Pancreatic cancer is described as the most lethal gastrointestinal cancer, with a low 5-year overall survival rate of around 12%. 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BMC Medicine (2023) 21:171 [https://doi.org/10.1186/s12916-023-02852-4](https://doi.org/10.1186/s12916-023-02852-4)  \nBMC Medicine  \n OPINION Open Access  \nCombination therapies for cancer: challenges and opportunities  \nZhijun Zhou1, Barish H. Edil2 and Min Li 1,2*  \nAbstract  \nBackground Gastrointestinal cancers represent a major challenge to public health. Pancreatic cancer is the most lethal cancer among all gastrointestinal cancers. Most patients cannot meet the criteria of resection at diagnosis, indicating these patients will have dismal prognosis.  \nMain text Neoadjuvant chemotherapy helps some patients regain the opportunity of radical resection. An optimal regimen of chemotherapy is one that maximizes the anti-tumor efficacy while maintaining a relatively manageable safety profile. The development of surgical procedures further improves the outcomes of these patients. Conclusions Combination therapies in a multidisciplinary manner that involves modified chemotherapy regimen, radical resection, and intestine auto-transplantation may provide the currently best possible care to patients with locally advanced pancreatic cancer.  \nKeywords Combinational therapy, Pancreatic cancer, Radical resection, Intestine auto-transplantation  \nBackground  \nGastrointestinal cancers account for around 25.8% of newly diagnosed cancers annually. Among them, pancreatic cancer is the most lethal cancer, with a 5-year overall survival rate of only around 12%. There are more than 495,700 new cases of pancreatic cancer each year [1]. Unfortunately, over 80% of these patients lost the opportunity of surgery at diagnosis. Neoadjuvant chemotherapy helps some patients regain the opportunity of radical resection, the only way for possible cure. Numerous efforts have been made in hopes of increasing the efficacy while decreasing the side effects of chemotherapy. A widely-used chemotherapy agent is gemcitabine, which is usually combined with other drugs as an adjuvant or  \n*Correspondence: Min Li [Min-Li@ouhsc.edu](Min-Li@ouhsc.edu)  \n1 Department of Medicine, The University of Oklahoma Health Sciences Center, 975 NE 10Th Street, BRC 1262A, Oklahoma City, OK 73104, USA  \n2 Department of Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA  \nneoadjuvant treatment option. The first-line chemotherapy regimen is FOLFIRINOX consisting of fluorouracil, leucovorin, irinotecan, and oxaliplatin. Although this regimen achieved a relatively satisfying anti-tumor effect on metastatic pancreatic cancer, it would inevitably bring undesirable adverse effects, which reduced treatment efficacy [2]. Optimizing the dose of the FOLFIRINOX regimen is critical for the treatment efficacy.  \nCombination therapy holds the promise  \nLiang and colleagues proposed a modified FOLFIRINOX regimen, consisting of 85% oxaliplatin, 75% irinotecan, and zero fluorouracil bolus [3]. This modification enhanced the tolerance against the FOLFIRINOX-related adverse events, without compromising the therapeutic efficacy. The median overall survival (OS) and progression-free survival (PFS) were 10.3 months and 7.0 months in metastatic pancreatic cancer patients with the treatment of the modified FOLFIRINOX regimen, comparable to 11.1 months and 6.4 months in patients receiving the traditional full-dose treatment [2]. For the elderly patients with advanced pancreatic cancer who  \n© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not inc","cbCaiuGFTF0Jv8DY","https://ap.wps.com/l/cbCaiuGFTF0Jv8DY","pdf",692847,"English","# Abstract\n# Background\n# Main text\n## Neoadjuvant chemotherapy and radical resection\n## Modified FOLFIRINOX regimen\n## Safety, tolerability, and patient selection\n# Conclusions","[{\"question\":\"Why is pancreatic cancer considered especially challenging among gastrointestinal cancers?\",\"answer\":\"Pancreatic cancer is described as the most lethal gastrointestinal cancer, with a low 5-year overall survival rate of around 12%. Most patients cannot meet resection criteria at diagnosis, leading to dismal prognosis.\"},{\"question\":\"How does neoadjuvant chemotherapy help in pancreatic cancer treatment?\",\"answer\":\"Neoadjuvant chemotherapy helps some patients regain the opportunity for radical resection, which is described as the only way for possible cure.\"},{\"question\":\"What combination approach is suggested as potentially best care for locally advanced pancreatic cancer?\",\"answer\":\"A multidisciplinary combination involving a modified chemotherapy regimen, radical resection, and intestine auto-transplantation is proposed as possibly providing the currently best available care.\"}]","Combination therapies for cancer - challenges and opportunities | PDF",1790232636]