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Cancers
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Current Clinical Studies of Pancreatic Ductal Adenocarcinoma
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Current Clinical Studies of Pancreatic Ductal Adenocarcinoma

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Clinical Research of Cancer".

Deadline for manuscript submissions: 20 April 2025 | Viewed by 7647

Special Issue Editor

Dr. Govindarajan Narayanan

E-Mail Website
Guest Editor
1. Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA
2. Miami Cardiac and Vascular, Baptist Health South Florida, Miami, FL 33176, USA
3. Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
Interests: HCC; pancreas cancer; cancer ablation; IRE; mCRC
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We would like to annnounce the launch of a Special Issue on ‘Current Clinical Studies of Pancreatic Ductal Adenocarcinoma’ which will take the form of a multi-disciplinary project, incoporating research on medical oncology, current trends in neoadjuvant and adjuvant chemotherapy for pancreatic cancer, and surgical managements such as open and minimally invasive techniques. This Special Issue will also highlight studies on the locoregional treatment space including advances in SBRT and MR-guided Linac along with irreversible electroporation (IRE) using an open surgical approach and a percutaneous approach. Additionally, bench research analyzing the role of local treatment in enhancing immune response and/or the impact of local treatment on the stromal tissue of pancreatic cancer, which improves the uptake of immunotherapy, will also be incorporated.

Dr. Govindarajan Narayanan
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

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Published Papers (6 papers)

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Research

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12 pages, 1115 KiB  
Article
Prognostic Significance of EGFR, HER2, and c-Met Overexpression in Surgically Treated Patients with Adenocarcinoma of the Ampulla of Vater
by Se Jun Park, Kabsoo Shin, Tae Ho Hong, Sung Hak Lee, In-Ho Kim, Younghoon Kim and MyungAh Lee
Cancers 2024, 16(15), 2756; https://doi.org/10.3390/cancers16152756 - 3 Aug 2024
Viewed by 909
Abstract
Adenocarcinoma of the ampulla of Vater (AAC) is a rare malignancy with heterogeneous tumors arising from various histologic subtypes, necessitating new therapeutic strategies. This study examines epidermal growth factor receptor (EGFR), human epidermal growth factor receptor 2 (HER2), and c-Met expression in AAC, [...] Read more.
Adenocarcinoma of the ampulla of Vater (AAC) is a rare malignancy with heterogeneous tumors arising from various histologic subtypes, necessitating new therapeutic strategies. This study examines epidermal growth factor receptor (EGFR), human epidermal growth factor receptor 2 (HER2), and c-Met expression in AAC, given their potential as druggable targets. Among 87 patients who underwent curative resection, EGFR overexpression was found in 87.4%, HER2 in 11.5%, and c-Met in 50%. EGFR overexpression was more common in the pancreatobiliary subtype (p = 0.018) and associated with a higher histologic grade (p = 0.008). HER2 did not correlate with clinicopathological features, while c-Met was more common in node-negative groups (p = 0.004) and often co-expressed with EGFR (p = 0.049). EGFR-positive patients had worse disease-free (HR = 2.89; 95% CI, 1.35–6.20; p = 0.061) and overall survival (HR = 6.89; 95% CI, 2.94–16.2; p = 0.026) than EGFR-negative patients. HER2-positive AAC showed a trend towards shorter survival, although not statistically significant, and c-Met had no impact on survival outcomes. In the context of systemic disease, survival outcomes did not vary according to EGFR, HER2, and c-Met expression, but the HER2-positive group showed a trend towards inferior progression-free survival (HR = 1.90; 95% CI, 0.56–6.41; p = 0.166). This study underscores the potential of EGFR, HER2, and c-Met as targets for personalized therapy in AAC, warranting further research to evaluate targeted treatments. Full article
(This article belongs to the Special Issue Current Clinical Studies of Pancreatic Ductal Adenocarcinoma)
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12 pages, 1803 KiB  
Article
Resection Margin Status and Long-Term Outcomes after Pancreaticoduodenectomy for Ductal Adenocarcinoma: A Tertiary Referral Center Analysis
by Giuseppe Quero, Davide De Sio, Claudio Fiorillo, Chiara Lucinato, Edoardo Panza, Beatrice Biffoni, Lodovica Langellotti, Vito Laterza, Giulia Scaglione, Flavia Taglioni, Giuseppe Massimiani, Roberta Menghi, Fausto Rosa, Teresa Mezza, Sergio Alfieri and Vincenzo Tondolo
Cancers 2024, 16(13), 2347; https://doi.org/10.3390/cancers16132347 - 26 Jun 2024
Viewed by 1169
Abstract
The influencing role of resection margin (R) status on long-term outcomes, namely overall (OS) and disease-free survival (DFS), after pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC) is not still clear. The aim of this study is to evaluate the prognostic impact of R [...] Read more.
The influencing role of resection margin (R) status on long-term outcomes, namely overall (OS) and disease-free survival (DFS), after pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC) is not still clear. The aim of this study is to evaluate the prognostic impact of R status after PD and to define tumor characteristics associated with a positive resection margin (R1). All PDs for PDAC performed between 2012 and 2023 were retrospectively enrolled. The effect of R status, patient clinico-demographic features, and tumor features on OS and DFS were assessed. One-hundred and sixty-seven patients who underwent PD for PDAC were included in the study. R0 was achieved in 105 cases (62.8%), while R1 was evidenced in 62 patients (37.1%). R1 was associated with a decreased OS (23 (13–38) months) as compared to R0 (36 (21–53) months) (p = 0.003). Similarly, DFS was shorter in R1 patients (10 (6–25) months) as compared to the R0 cohort (18 (9–70) months) (p = 0.004), with a consequent higher recurrence rate in cases of R1 (74.2% vs. 64.8% in the R0 group; p = 0.04). In the multivariate analysis, R1 and positive lymph nodes (N+) were the only independent influencing factors for OS (OR: 1.6; 95% CI: 1–2.5; p = 0.03 and OR: 1.7; 95% CI: 1–2.8; p = 0.04) and DFS (OR: 1.5; 95% CI: 1–2.1; p = 0.04 and OR: 1.8; 95% CI: 1.1–2.7; p = 0.009). Among 111 patients with N+ disease, R1 was associated with a significantly decreased DFS (10 (8–11) months) as compared to R0N+ patients (16 (11–21) months) (p = 0.05). In conclusion, the achievement of a negative resection margin is associated with survival benefits, particularly in cases of N1 disease. In addition, R0 was recognized as an independent prognostic feature for both OS and DFS. This further outlines the relevant role of radical surgery on long-term outcomes. Full article
(This article belongs to the Special Issue Current Clinical Studies of Pancreatic Ductal Adenocarcinoma)
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9 pages, 2583 KiB  
Article
Prognostic Impact of Mucin Expression in Curatively Resected Ampulla of Vater Cancer
by Byeong Gwan Noh, Hyung Il Seo, Young Mok Park, Su-Bin Song, Suk Kim, Seung Baek Hong, Nam Kyung Lee, Jonghyun Lee, Tae In Kim, Chae Hwa Kwon and Ji Hyun Ahn
Cancers 2024, 16(11), 2120; https://doi.org/10.3390/cancers16112120 - 1 Jun 2024
Viewed by 899
Abstract
Introduction: Mucins play a pivotal role in epithelial carcinogenesis; however, their role remains elusive in ampulla of Vater (AoV) cancer, regardless of histological subtype. Therefore, we investigated the clinical significance of MUC1, MUC2, MUC5AC, and MUC6 expression in AoV cancer. Methods: Using [...] Read more.
Introduction: Mucins play a pivotal role in epithelial carcinogenesis; however, their role remains elusive in ampulla of Vater (AoV) cancer, regardless of histological subtype. Therefore, we investigated the clinical significance of MUC1, MUC2, MUC5AC, and MUC6 expression in AoV cancer. Methods: Using samples from 68 patients with AoV cancer, we performed immunohistochemical staining for MUC1, MUC2, MUC5AC, and MUC6 using a tissue microarray. Subsequently, we analyzed their expression patterns in relation to clinicopathological parameters and patient outcomes. Results: Of the patients, 98.5% exhibited positive expression for MUC1, while MUC2, MUC5AC, and MUC6 were expressed in 44.1%, 47.1%, and 41.2% of the patients, respectively. Correlation analyses between mucin expression and clinicopathological factors revealed no significant associations, except between MUC5AC expression and N stage. Univariate analysis demonstrated significant associations between MUC5AC expression and overall survival (OS). Multivariate analysis further confirmed that MUC5AC expression was a significant predictor of OS, along with the N stage. However, MUC5AC expression was not meaningfully associated with recurrence-free survival (RFS). The patients positive for MUC5AC expression had a considerably shorter OS than those with negative expression. Conclusions: Our study provides insights into the clinical impact of mucins on AoV cancer, regardless of the histological subtype. Although MUC1 expression is universal, MUC5AC expression is a significant prognostic indicator that correlates with lymph node metastasis and poor OS. These results emphasize the possible utility of MUC5AC as a biomarker for extensive lymph node dissection and the prognostic evaluation of patients with AoV cancer. Full article
(This article belongs to the Special Issue Current Clinical Studies of Pancreatic Ductal Adenocarcinoma)
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Review

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17 pages, 625 KiB  
Review
Targeting Neoantigens in Pancreatic Ductal Adenocarcinoma
by Gurkaranjot Singh, Drew Kutcher, Rajeshwar Lally and Vikrant Rai
Cancers 2024, 16(11), 2101; https://doi.org/10.3390/cancers16112101 - 31 May 2024
Cited by 4 | Viewed by 1351
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is the most common type of pancreatic cancer and is currently the third leading cause of cancer-related death in the United States after lung and colon cancer. PDAC is estimated to be the second leading cause of cancer-related death [...] Read more.
Pancreatic ductal adenocarcinoma (PDAC) is the most common type of pancreatic cancer and is currently the third leading cause of cancer-related death in the United States after lung and colon cancer. PDAC is estimated to be the second leading cause of cancer-related death by 2030. The diagnosis at a late stage is the underlying cause for higher mortality and poor prognosis after surgery. Treatment resistance to chemotherapy and immunotherapy results in recurrence after surgery and poor prognosis. Neoantigen burden and CD8+ T-cell infiltration are associated with clinical outcomes in PDAC and paucity of neoantigen-reactive tumor-infiltrating lymphocytes may be the underlying cause for treatment resistance for immunotherapy. This suggests a need to identify additional neoantigens and therapies targeting these neoantigens to improve clinical outcomes in PDAC. In this review, we focus on describing the pathophysiology, current treatment strategies, and treatment resistance in PDAC followed by the need to target neoantigens in PDAC. Full article
(This article belongs to the Special Issue Current Clinical Studies of Pancreatic Ductal Adenocarcinoma)
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25 pages, 9517 KiB  
Review
Controversies in Endoscopic Ultrasound-Guided Biliary Drainage
by Christoph Frank Dietrich, Paolo Giorgio Arcidiacono, Manoop S. Bhutani, Barbara Braden, Eike Burmester, Pietro Fusaroli, Michael Hocke, Andrè Ignee, Christian Jenssen, Abed Al-Lehibi, Emad Aljahdli, Bertrand Napoléon, Mihai Rimbas and Giuseppe Vanella
Cancers 2024, 16(9), 1616; https://doi.org/10.3390/cancers16091616 - 23 Apr 2024
Cited by 1 | Viewed by 1147
Abstract
In this 14th document in a series of papers entitled “Controversies in Endoscopic Ultrasound” we discuss various aspects of EUS-guided biliary drainage that are debated in the literature and in practice. Endoscopic retrograde cholangiography is still the reference technique for therapeutic [...] Read more.
In this 14th document in a series of papers entitled “Controversies in Endoscopic Ultrasound” we discuss various aspects of EUS-guided biliary drainage that are debated in the literature and in practice. Endoscopic retrograde cholangiography is still the reference technique for therapeutic biliary access, but EUS-guided techniques for biliary access and drainage have developed into safe and highly effective alternative options. However, EUS-guided biliary drainage techniques are technically demanding procedures for which few training models are currently available. Different access routes require modifications to the basic technique and specific instruments. In experienced hands, percutaneous transhepatic cholangiodrainage is also a good alternative. Therefore, in this paper, we compare arguments for different options of biliary drainage and different technical modifications. Full article
(This article belongs to the Special Issue Current Clinical Studies of Pancreatic Ductal Adenocarcinoma)
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14 pages, 991 KiB  
Review
Involvement of the Gut Microbiome in the Local and Systemic Immune Response to Pancreatic Ductal Adenocarcinoma
by James M. Halle-Smith, Hayden Pearce, Samantha Nicol, Lewis A. Hall, Sarah F. Powell-Brett, Andrew D. Beggs, Tariq Iqbal, Paul Moss and Keith J. Roberts
Cancers 2024, 16(5), 996; https://doi.org/10.3390/cancers16050996 - 29 Feb 2024
Cited by 1 | Viewed by 1666
Abstract
The systemic and local immunosuppression exhibited by pancreatic ductal adenocarcinoma (PDAC) contributes significantly to its aggressive nature. There is a need for a greater understanding of the mechanisms behind this profound immune evasion, which makes it one of the most challenging malignancies to [...] Read more.
The systemic and local immunosuppression exhibited by pancreatic ductal adenocarcinoma (PDAC) contributes significantly to its aggressive nature. There is a need for a greater understanding of the mechanisms behind this profound immune evasion, which makes it one of the most challenging malignancies to treat and thus one of the leading causes of cancer death worldwide. The gut microbiome is now thought to be the largest immune organ in the body and has been shown to play an important role in multiple immune-mediated diseases. By summarizing the current literature, this review examines the mechanisms by which the gut microbiome may modulate the immune response to PDAC. Evidence suggests that the gut microbiome can alter immune cell populations both in the peripheral blood and within the tumour itself in PDAC patients. In addition, evidence suggests that the gut microbiome influences the composition of the PDAC tumour microbiome, which exerts a local effect on PDAC tumour immune infiltration. Put together, this promotes the gut microbiome as a promising route for future therapies to improve immune responses in PDAC patients. Full article
(This article belongs to the Special Issue Current Clinical Studies of Pancreatic Ductal Adenocarcinoma)
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