Progress in the Treatment of Pancreatic Cancer—How Can the Latest Scientific Developments be Implemented in Clinical Practice?

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

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 6848

Special Issue Editors


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Guest Editor
Department of General, Visceral and Vascular Surgery, Salzkammergutklinikum, OÖG, Vöcklabruck, Austria
Interests: pancreatic cancer; pancreatic neuroendocrine neoplasm; hepatobiliary surgery; surgical oncology; liver metastasis; neuroendocrine tumours

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Guest Editor
Department of General, Visceral and Vascular Surgery, Salzkammergutklinikum, OÖG, Vöcklabruck, Austria
Interests: pancreatic cancer; pancreatic neuroendocrine neoplasm; hepatobiliary surgery; surgical oncology; liver metastasis; neuroendocrine tumours; medical statistics
Department of General, Visceral and Vascular Surgery, Salzkammergut Klinikum, OÖG, Vöcklabruck, Austria
Interests: pancreatic cancer; pancreatic neuroendocrine neoplasm; surgical oncology; neuroendocrine tumours; molecular biology; tumour development; biobanking

Special Issue Information

Pancreatic cancer (PDAC) is a deadly disease. While surgical resection can offer a better prognosis in some, over 70% of tumors present as locally advanced or late-stage.

Over the last few decades, some progress has been made, with the overall 5-year survival rate now at about 9% from 2.5% in the 1970s. Much of this improvement has been driven by high-quality clinical studies on (neo)adjuvant treatment strategies, along with our expanded understanding of the tumor biology and molecular markers. Some of these expression studies include BRCA1, BRCA2, KRAS, SMAD4, and DNA mismatch repair genes. High-throughput genome sequence analyses have also been performed in the hope of generating targeted therapies and personalized treatments. How all of this information will improve prognosis and translate into clinical practice remains to be seen. 

In this Special Issue, we aim to present original research articles that will highlight the progress in the diagnosis, treatment, and follow-up of PDACs, along with the potential challenges. Topics of interest include: which cases would benefit from neoadjuvant therapy, staged resection, and/or immunotherapy? How can we minimize perioperative complications and improve post-operative outcomes? Is early detection and screening of pancreatic cancers possible? How close (or far away) are we to providing personalized medicine for individualized and targeted treatments?

Prof. Stefan Stättner
Dr. Florian Primavesi
Dr. Alvin Lin
Guest Editors

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Keywords

  • pancreatic cancer
  • pancreatic ductal adenocarcinoma
  • tumor biology
  • molecular markers
  • neoadjuvant therapy
  • adjuvant therapy
  • multidisciplinary approach

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Published Papers (2 papers)

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Research

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14 pages, 4289 KiB  
Article
Definition of Local Recurrence Site in Resected Pancreatic Adenocarcinoma: A Multicenter Study (DOLORES-1)
by Alessandra Arcelli, Federica Bertini, Silvia Strolin, Gabriella Macchia, Francesco Deodato, Savino Cilla, Salvatore Parisi, Aldo Sainato, Michele Fiore, Pietro Gabriele, Domenico Genovesi, Francesco Cellini, Alessandra Guido, Silvia Cammelli, Milly Buwenge, Emiliano Loi, Silvia Bisello, Matteo Renzulli, Rita Golfieri, Alessio G. Morganti and Lidia Strigariadd Show full author list remove Hide full author list
Cancers 2021, 13(12), 3051; https://doi.org/10.3390/cancers13123051 - 18 Jun 2021
Cited by 1 | Viewed by 2187
Abstract
The study aimed to generate a local failure (LF) risk map in resected pancreatic cancer (PC) and validate the results of previous studies, proposing new guidelines for PC postoperative radiotherapy clinical target volume (CTV) delineation. Follow-up computer tomography (CT) of resected PC was [...] Read more.
The study aimed to generate a local failure (LF) risk map in resected pancreatic cancer (PC) and validate the results of previous studies, proposing new guidelines for PC postoperative radiotherapy clinical target volume (CTV) delineation. Follow-up computer tomography (CT) of resected PC was retrospectively reviewed by two radiologists identifying LFs and plotting them on a representative patient CT scan. The percentages of LF points randomly extracted based on CTV following the RTOG guidelines and based on the LF database were 70% and 30%, respectively. According to the Kernel density estimation, an LF 3D distribution map was generated and compared with the results of previous studies using a Dice index. Among the 64 resected patients, 59.4% underwent adjuvant treatment. LFs closer to the root of the celiac axis (CA) or the superior mesenteric artery (SMA) were reported in 32.8% and 67.2% cases, respectively. The mean (± standard deviation) distances of LF points to CA and SMA were 21.5 ± 17.9 mm and 21.6 ± 12.1 mm, respectively. The Dice values comparing our iso-level risk maps corresponding to 80% and 90% of the LF probabilistic density and the CTVs-80 and CTVs-90 of previous publications were 0.45–0.53 and 0.58–0.60, respectively. According to the Kernel density approach, a validated LF map was proposed, modeling a new adjuvant CTV based on a PC pattern of failure. Full article
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19 pages, 2137 KiB  
Review
Micro- and Mycobiota Dysbiosis in Pancreatic Ductal Adenocarcinoma Development
by Ruben Bellotti, Cornelia Speth, Timon E. Adolph, Cornelia Lass-Flörl, Maria Effenberger, Dietmar Öfner and Manuel Maglione
Cancers 2021, 13(14), 3431; https://doi.org/10.3390/cancers13143431 - 8 Jul 2021
Cited by 21 | Viewed by 3759
Abstract
Background: Dysbiosis of the intestinal flora has emerged as an oncogenic contributor in different malignancies. Recent findings suggest a crucial tumor-promoting role of micro- and mycobiome alterations also in the development of pancreatic ductal adenocarcinoma (PDAC). Methods: To summarize the current knowledge about [...] Read more.
Background: Dysbiosis of the intestinal flora has emerged as an oncogenic contributor in different malignancies. Recent findings suggest a crucial tumor-promoting role of micro- and mycobiome alterations also in the development of pancreatic ductal adenocarcinoma (PDAC). Methods: To summarize the current knowledge about this topic, a systematic literature search of articles published until October 2020 was performed in MEDLINE (PubMed). Results: An increasing number of publications describe associations between bacterial and fungal species and PDAC development. Despite the high inter-individual variability of the commensal flora, some studies identify specific microbial signatures in PDAC patients, including oral commensals like Porphyromonas gingivalis and Fusobacterium nucleatum or Gram-negative bacteria like Proteobacteria. The role of Helicobacter spp. remains unclear. Recent isolation of Malassezia globosa from PDAC tissue suggest also the mycobiota as a crucial player of tumorigenesis. Based on described molecular mechanisms and interactions between the pancreatic tissue and the immune system this review proposes a model of how the micro- and the mycobial dysbiosis could contribute to tumorigenesis in PDAC. Conclusions: The presence of micro- and mycobial dysbiosis in pancreatic tumor tissue opens a fascinating perspective on PDAC oncogenesis. Further studies will pave the way for novel tumor markers and treatment strategies. Full article
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