Pancreatic cancer remains one of the major causes of
cancer-related mortality. The majority of
pancreatic cancer patients are diagnosed at the advanced stage with unresectable and drug resistant
tumors. The new treatments with the combination of
chemotherapy,
molecular targeted therapy, and
immunotherapy have shown modest effects on therapeutic efficacy and survival of the patients. Therefore, there is an urgent need to develop effective therapeutic approaches targeting highly heterogeneous
pancreatic cancer cells and tumor microenvironments. Recent advances in
biomarker targeted
cancer therapy and image-guided drug delivery and monitoring treatment response using multifunctional nanoparticles, also referred to as
theranostic nanoparticles, offer a new opportunity of effective detection and treatment of
pancreatic cancer. Increasing evidence from preclinical studies has shown the potential of applications of
theranostic nanoparticles for designing precision oncology approaches for
pancreatic cancer therapy. In this review, we provide an update on the current understanding and strategies for the development of targeted
therapy for
pancreatic cancer using nanoparticle
drug carriers. We address issues concerning drug delivery barriers in stroma rich
pancreatic cancer and the potential approaches to improve drug delivery efficiency, therapeutic responses and
tumor imaging. Research results presented in this review suggest the development of an integrated
therapy protocol through image-guided and targeted drug delivery and
therapeutic effect monitoring as a promising precision oncology strategy for
pancreatic cancer treatment.