Review

Apoptotic pathways in pancreatic ductal adenocarcinoma

Rainer Hamacher , Roland M Schmid , Dieter Saur and Günter Schneider

II. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, München, Germany

author email corresponding author email

Molecular Cancer 2008, 7:64doi:10.1186/1476-4598-7-64

Published:	24 July 2008

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is one of the most common causes of cancer related death. Despite the advances in understanding of the molecular pathogenesis, pancreatic cancer remains a major unsolved health problem. Overall, the 5-year survival rate is less than 5% demonstrating the insufficiency of current therapies.

Most cytotoxic therapies induce apoptosis and PDAC cells have evolved a plethora of molecular mechanisms to assure survival. We will present anti-apoptotic strategies working at the level of the death receptors, the mitochondria or involving the caspase inhibitors of the IAP family. Furthermore, the survival function of the phosphotidylinositol-3' kinase (PI3K)/AKT- and NF-kappaB-pathways are illustrated. A detailed molecular knowledge of the anti-apoptotic mechanisms of PDAC cells will help to improve therapies for this dismal disease and therapeutic strategies targeting the programmed cell death machinery are in early preclinical and clinical development.