Jiang Yan, Sohal Davendra P S
University of Cincinnati, Cincinnati, OH.
JCO Oncol Pract. 2023 Jan;19(1):19-32. doi: 10.1200/OP.22.00328. Epub 2022 Sep 22.
The management of pancreatic ductal adenocarcinoma (PDAC) has evolved over the last two decades. Surgical resection remain the only potential cure for this cancer. Therefore, there is an emerging emphasis on neoadjuvant therapy to maximize the probability of resection, and identify failures early. The benefit of FOLFIRINOX in various clinical stages of PDAC have been practice changing. The addition of nab-paclitaxel to the traditional gemcitabine regimen added another option for treatment. In addition, immunotherapy and targeted therapies are applicable, based on molecular features and germline alterations; albeit, these are applicable to only a small minority of patients. In this review article, we discuss the key extant literature relevant to various stages of pancreatic cancer. We also summarize ongoing clinical trials which may guide future treatments.
在过去二十年中,胰腺导管腺癌(PDAC)的治疗方法不断演变。手术切除仍然是这种癌症唯一可能的治愈方法。因此,越来越强调新辅助治疗,以最大限度地提高切除概率,并尽早发现治疗失败情况。FOLFIRINOX方案在PDAC各个临床阶段的疗效已改变了临床实践。在传统吉西他滨方案中加入白蛋白结合型紫杉醇又增加了一种治疗选择。此外,基于分子特征和种系改变,免疫疗法和靶向疗法也适用;尽管这些疗法仅适用于少数患者。在这篇综述文章中,我们讨论了与胰腺癌各个阶段相关的关键现有文献。我们还总结了正在进行的可能指导未来治疗的临床试验。