Role of radiotherapy in combination with chemotherapy, targeted therapy, and immunotherapy in the management of pancreatic cancer

Currently, pancreatic ductal adenocarcinoma (PDAC) remains a highly lethal disease despite advances in multimodality therapy. Themajority of patientswith PDAC present with locally advanced or metastatic disease, and additional therapies or treatment paradigms are needed to improve progression-free survival and overall survival. Alternate therapies, such as a nanoparticle albumin-bound form of paclitaxel, epidermal growth factor receptor (EGFR) inhibitors, vascular endothelial growth factor (VEGF) inhibitors, and poly(ADP-ribose) polymerase (PARP) 1/2 inhibitors have been investigated for potential synergy with systemic agents in PDAC. Here, we review the current status of radiotherapy combined with systemic therapies for pancreatic cancer, with a focus on these targeted agents, novel immunotherapies, and discussion of the Abscopal effect.