Silvestris Nicola, Longo Vito, Cellini Francesco, Reni Michele, Bittoni Alessandro, Cataldo Ivana, Partelli Stefano, Falconi Massimo, Scarpa Aldo, Brunetti Oronzo, Lorusso Vito, Santini Daniele, Morganti Alessio, Valentini Vincenzo, Cascinu Stefano
Medical Oncology Unit, National Cancer Research Centre "Giovanni Paolo II", Bari, Italy.
Medical Oncology Unit, 'Mons R Dimiccoli' Hospital, Barletta, Italy.
Crit Rev Oncol Hematol. 2016 Feb;98:309-24. doi: 10.1016/j.critrevonc.2015.11.016. Epub 2015 Nov 23.
Treatment of pancreatic ductal adenocarcinoma (PDAC) is increasingly multidisciplinary, with neoadjuvant strategies (chemotherapy, radiation, and surgery) administered in patients with resectable, borderline resectable, or locally advanced disease. The rational supporting this management is the achievement of both higher margin-negative resections and conversion rates into potentially resectable disease and in vivo assessment of novel therapeutics. International guidelines suggest an initial staging of the disease followed by a multidisciplinary approach, even considering the lack of a treatment approach to be considered as standard in this setting. This review will focus on both literature data supporting these guidelines and on new opportunities related to current more active chemotherapy regimens. An analysis of the pathological assessment of response to therapy and the potential role of target therapies and translational biomarkers and ongoing clinical trials of significance will be discussed.
胰腺导管腺癌（PDAC）的治疗越来越多地采用多学科方法，对于可切除、边界可切除或局部晚期疾病的患者采用新辅助治疗策略（化疗、放疗和手术）。支持这种治疗方式的理论依据是实现更高比例的切缘阴性切除以及将疾病转化为潜在可切除状态，并对新型疗法进行体内评估。国际指南建议对疾病进行初始分期，然后采用多学科方法，即使在这种情况下缺乏被视为标准的治疗方法。本综述将聚焦于支持这些指南的文献数据以及与当前更积极的化疗方案相关的新机遇。还将讨论对治疗反应的病理评估分析、靶向治疗和转化生物标志物的潜在作用以及正在进行的具有重要意义的临床试验。
