Department of General Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham Queen Elizabeth, Birmingham, UK; Institute of Immunology and Immunotherapy, University of Birmingham, UK.
Division of Transplantation, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
Surg Oncol. 2022 Aug;43:101803. doi: 10.1016/j.suronc.2022.101803. Epub 2022 Jul 7.
The seventh leading cause of cancer-related death globally, pancreatic ductal adenocarcinoma (PDAC) involves the exocrine pancreas and constitutes greater than 90% of all pancreatic cancers. Surgical resection in combination with systemic chemotherapy with or without radiation remains the mainstay of treatment and the only potentially curative treatment option. While there has been improvement in systemic chemotherapy, long-term survival among patients with PDAC remains poor. Improvement in the understanding of tumorigenesis, genetic mutations, the tumor microenvironment (TME), immunotherapies, as well as targeted therapies continued to drive advances in PDAC treatment. We herein review the TME, genetic landscape, as well as various metabolic pathways associated with PDAC tumorigenesis relative to emerging therapies.
全球第七大致癌相关死亡原因，胰腺导管腺癌（PDAC）涉及外分泌胰腺，占所有胰腺癌的 90%以上。手术切除联合系统化疗（伴或不伴放疗）仍然是主要的治疗方法，也是唯一潜在的治愈性治疗选择。尽管系统化疗有所改善，但 PDAC 患者的长期生存率仍然很差。对肿瘤发生、遗传突变、肿瘤微环境（TME）、免疫疗法以及靶向治疗的理解的提高继续推动 PDAC 治疗的进展。本文综述了与新兴疗法相关的 PDAC 肿瘤发生的 TME、遗传图谱以及各种代谢途径。
