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Cancers
Special Issues
Research Updates in Pancreatic Ductal Adenocarcinoma
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Research Updates in Pancreatic Ductal Adenocarcinoma

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Causes, Screening and Diagnosis".

Deadline for manuscript submissions: closed (31 May 2023) | Viewed by 9115

Special Issue Editors

Dr. Vincent Chung

E-Mail Website
Guest Editor
Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA 91010, USA
Interests: pancreatic cancer; phase I trials
Special Issues, Collections and Topics in MDPI journals
Dr. Gagandeep Singh

E-Mail Website
Guest Editor
Division of Surgical Oncology, City of Hope Medical Center, Duarte, CA 91010, USA
Interests: pancreatic cancer; robotic and laparoscopic surgery; gallbladder and bile duct cancer; liver cancer and metastases; neuroendocrine tumors (NETs); ablations—microwave ablations and nanoknife ablations
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Pancreatic cancer has the worst survival rate of any solid tumor, and by 2030, it is anticipated to be the second leading cause of cancer death. Over the last decade, we have seen the five-year survival increase to 11% of patients with improvements in management. Chemotherapeutics have improved with higher response rates, and with better management of toxicities, we have been able to keep patients on treatment for longer periods of time. This has led to the inclusion of maintenance therapy in the NCCN guidelines. Genomics has also been critical in understanding how to keep driving pathways in pancreatic cancer, and we are learning about pancreatic subtypes that may predict response to treatment. Targeted therapies have been shown to improve survival in this deadly disease.

Dear Colleagues,

Pancreatic cancer is an incredibly deadly disease, as you all know. Your research has been vital to the advancement in the care of patients suffering from this disease. Indeed, fifteen years ago, the median overall survival was only about 6 months, but now we have patients who survive for many years. This Special Issue highlights the ground-breaking work that you have accomplished.

We are pleased to invite you to contribute an article in this Special Issue discussing novel treatment approaches for advanced pancreatic cancer with the following aims:

  • Reviewing the management of advanced pancreatic cancer;
  • Discussing the role of neoadjuvant therapy;
  • Discussing the role of radiation therapy and research improving efficacy of radiation therapy;
  • Reviewing progress in molecularly targeted therapy;
  • Targeting DNA damage pathways in pancreatic cancer;
  • Achieving advances in surgical management;
  • Determining the role of the tumor microenvironment;
  • Improving treatment approaches and supportive care in older adults.

We realize how busy you are and wanted to give you ample time to complete your article. Additionally, we encourage you to recruit junior faculty or students to assist you in writing the review. We aim to bring together leaders in the field in this Special Issue and look forward to your contribution.

Dr. Vincent Chung
Dr. Gagandeep Singh
Guest Editors

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.

Keywords

  • pancreatic cancer
  • targeted therapy
  • neoadjuvant treatment
  • radiation therapy
  • immunotherapy
  • CAR-T
  • maintenance therapy
  • novel surgical management
  • tumor microenvironment
  • DNA damage repair

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Further information on MDPI's Special Issue polices can be found here.

Published Papers (3 papers)

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13 pages, 687 KiB  
Article
Maintenance Treatment for Metastatic Pancreatic Cancer: Balancing Therapeutic Intensity with Tolerable Toxicity
by Evan J. Walker and Andrew H. Ko
Cancers 2023, 15(14), 3657; https://doi.org/10.3390/cancers15143657 - 18 Jul 2023
Viewed by 2697
Abstract
Metastatic pancreatic ductal adenocarcinoma is typically treated with multi-agent chemotherapy until disease progression or intolerable cumulative toxicity. For patients whose disease shows ongoing control or response beyond a certain timeframe (≥3–4 months), options include pausing chemotherapy with close monitoring or de-escalating to maintenance [...] Read more.
Metastatic pancreatic ductal adenocarcinoma is typically treated with multi-agent chemotherapy until disease progression or intolerable cumulative toxicity. For patients whose disease shows ongoing control or response beyond a certain timeframe (≥3–4 months), options include pausing chemotherapy with close monitoring or de-escalating to maintenance therapy with the goal of prolonging progression-free and overall survival while preserving quality of life. There is currently no universally accepted standard of care and a relative dearth of randomized clinical trials in the maintenance setting. Conceptually, such therapy can entail continuing the least toxic components of a first-line regimen and/or introducing novel agent(s) such as the poly(ADP-ribose) polymerase inhibitor olaparib, which is presently the only approved drug for maintenance treatment and is limited to a genetically defined subset of patients. In addition to identifying new therapeutic candidates and combinations in the maintenance setting, including targeted agents and immunotherapies, future research should focus on better understanding this unique biologic niche and how treatment in the maintenance setting may be distinct from resistant/refractory disease; identifying molecular predictors for more effective pairing of specific treatments with patients most likely to benefit; and establishing patient-reported outcomes in clinical trials to ensure accurate capture of quality of life metrics. Full article
(This article belongs to the Special Issue Research Updates in Pancreatic Ductal Adenocarcinoma)
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Review

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15 pages, 294 KiB  
Review
Advances in Radiation Oncology for Pancreatic Cancer: An Updated Review
by Jason Liu, Percy Lee, Heather M. McGee, Vincent Chung, Laleh Melstrom, Gagandeep Singh, Mustafa Raoof, Arya Amini, Yi-Jen Chen and Terence M. Williams
Cancers 2022, 14(23), 5725; https://doi.org/10.3390/cancers14235725 - 22 Nov 2022
Cited by 7 | Viewed by 2335
Abstract
This review aims to summarize the recent advances in radiation oncology for pancreatic cancer. A systematic search of the MEDLINE/PubMed database and Clinicaltrials.gov was performed, focusing on studies published within the last 10 years. Our search queried “locally advanced pancreatic cancer [AND] stereotactic [...] Read more.
This review aims to summarize the recent advances in radiation oncology for pancreatic cancer. A systematic search of the MEDLINE/PubMed database and Clinicaltrials.gov was performed, focusing on studies published within the last 10 years. Our search queried “locally advanced pancreatic cancer [AND] stereotactic body radiation therapy (SBRT) [OR] hypofractionation [OR] magnetic resonance guidance radiation therapy (MRgRT) [OR] proton” and “borderline resectable pancreatic cancer [AND] neoadjuvant radiation” and was limited only to prospective and retrospective studies and metanalyses. For locally advanced pancreatic cancers (LAPC), retrospective evidence supports the notion of radiation dose escalation to improve overall survival (OS). Novel methods for increasing the dose to high risk areas while avoiding dose to organs at risk (OARs) include SBRT or ablative hypofractionation using a simultaneous integrated boost (SIB) technique, MRgRT, or charged particle therapy. The use of molecularly targeted agents with radiation to improve radiosensitization has also shown promise in several prospective studies. For resectable and borderline resectable pancreatic cancers (RPC and BRPC), several randomized trials are currently underway to study whether current neoadjuvant regimens using radiation may be improved with the use of the multi-drug regimen FOLFIRINOX or immune checkpoint inhibitors. Full article
(This article belongs to the Special Issue Research Updates in Pancreatic Ductal Adenocarcinoma)
19 pages, 3605 KiB  
Review
Neural Component of the Tumor Microenvironment in Pancreatic Ductal Adenocarcinoma
by Michał Gola, Aleksandra Sejda, Janusz Godlewski, Małgorzata Cieślak and Anna Starzyńska
Cancers 2022, 14(21), 5246; https://doi.org/10.3390/cancers14215246 - 26 Oct 2022
Cited by 6 | Viewed by 3515
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive primary malignancy of the pancreas, with a dismal prognosis and limited treatment options. It possesses a unique tumor microenvironment (TME), generating dense stroma with complex elements cross-talking with each other to promote tumor growth and [...] Read more.
Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive primary malignancy of the pancreas, with a dismal prognosis and limited treatment options. It possesses a unique tumor microenvironment (TME), generating dense stroma with complex elements cross-talking with each other to promote tumor growth and progression. Diversified neural components makes for not having a full understanding of their influence on its aggressive behavior. The aim of the study was to summarize and integrate the role of nerves in the pancreatic tumor microenvironment. The role of autonomic nerve fibers on PDAC development has been recently studied, which resulted in considering the targeting of sympathetic and parasympathetic pathways as a novel treatment opportunity. Perineural invasion (PNI) is commonly found in PDAC. As the severity of the PNI correlates with a poorer prognosis, new quantification of this phenomenon, distinguishing between perineural and endoneural invasion, could feature in routine pathological examination. The concepts of cancer-related neurogenesis and axonogenesis in PDAC are understudied; so, further research in this field may be warranted. A better understanding of the interdependence between the neural component and cancer cells in the PDAC microenvironment could bring new nerve-oriented treatment options into clinical practice and improve outcomes in patients with pancreatic cancer. In this review, we aim to summarize and integrate the current state of knowledge and future challenges concerning nerve–cancer interactions in PDAC. Full article
(This article belongs to the Special Issue Research Updates in Pancreatic Ductal Adenocarcinoma)
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