Bai Ri-Lan, Wang Nan-Ya, Zhao Ling-Ling, Zhang Yong-Fei, Cui Jiu-Wei
Cancer Center, the First Hospital of Jilin University, Changchun 130021, China.
Cancer Center, the First Hospital of Jilin University, Changchun 130021, China.
Hepatobiliary Pancreat Dis Int. 2022 Feb;21(1):10-24. doi: 10.1016/j.hbpd.2021.08.012. Epub 2021 Sep 8.
Pancreatic ductal adenocarcinoma (PDAC) is a common cause of cancer-related death, and most patients are with advanced disease when diagnosed. At present, despite a variety of treatments have been developed for PDAC, few effective treatment options are available; on the other hand, PDAC shows significant resistance to chemoradiotherapy, targeted therapy, and immunotherapy due to its heterogeneous genetic profile, molecular signaling pathways, and complex tumor immune microenvironment. Nevertheless, over the past decades, there have been many new advances in the key theory and understanding of the intrinsic mechanisms and complexity of molecular biology and molecular immunology in pancreatic cancer, based on which more and more diverse new means and reasonable combination strategies for PDAC treatment have been developed and preliminary breakthroughs have been made. With the continuous exploration, from surgical local treatment to comprehensive medical management, the research-diagnosis-management system of pancreatic cancer is improving. This review focused on the variety of treatments for advanced PDAC, including traditional chemotherapy, targeted therapy, immunotherapy, microenvironment matrix regulation as well as the treatment targeting epigenetics, metabolism and cancer stem cells. We pointed out the current research bottlenecks and future exploration directions.
胰腺导管腺癌（PDAC）是癌症相关死亡的常见原因，大多数患者在确诊时已处于晚期。目前，尽管针对PDAC已开发出多种治疗方法，但有效的治疗选择却很少；另一方面，由于其基因异质性、分子信号通路以及复杂的肿瘤免疫微环境，PDAC对放化疗、靶向治疗和免疫治疗表现出显著抗性。然而，在过去几十年中，胰腺癌分子生物学和分子免疫学的内在机制及复杂性的关键理论和认识取得了许多新进展，在此基础上，已开发出越来越多样的PDAC治疗新方法和合理的联合策略，并取得了初步突破。随着不断探索，从手术局部治疗到综合医疗管理，胰腺癌的研究-诊断-管理体系正在不断完善。本综述重点关注晚期PDAC的各种治疗方法，包括传统化疗、靶向治疗、免疫治疗、微环境基质调节以及针对表观遗传学、代谢和癌症干细胞的治疗。我们指出了当前的研究瓶颈和未来的探索方向。
