Picozzi Vincent J
Virginia Mason Hospital and Medical Center, Seattle, Washington, USA.
Int J Surg. 2024 Oct 1;110(10):6070-6080. doi: 10.1097/JS9.0000000000000877.
Outcomes in pancreatic ductal adenocarcinoma (PDAC) remain poor due to a variety of biological, clinical, and societal factors. However, in recent years, PDAC has seen 1) increased precision of initial evaluation, 2) increased emphasis on supportive care, 3) deeper understanding of the translation biology of PDAC, especially as pertains to genomic alterations, and 4) foundational combination chemotherapy clinical trials across all disease stages. These advances have led to a wide range of new approaches to drug therapy for PDAC. Currently available drugs are showing added benefit, both by resequencing them with each other and also with respect to other therapeutic modalities. Molecular strategies are being developed to predict response to known therapeutic agents and to identify others. Additionally, a wide range of new drugs for PDAC are under development, including drugs which inhibit critical molecular pathways, drugs which attempt to capitalize on homologous repair deficiencies, immunotherapeutic approaches, antimetabolic agents, and drugs which attack the extracellular matrix which supports PDAC growth. These new approaches offer the promise of improved survival for future PDAC patients.
由于多种生物学、临床和社会因素，胰腺导管腺癌（PDAC）的治疗结果仍然很差。然而，近年来，PDAC出现了以下情况：1）初始评估的精准度提高；2）对支持性治疗的重视增加；3）对PDAC转化生物学的理解更加深入，尤其是与基因组改变相关的方面；4）针对所有疾病阶段开展了基础联合化疗临床试验。这些进展催生了一系列针对PDAC的新型药物治疗方法。目前可用的药物正在显示出额外的益处，这既体现在它们相互重新排序方面，也体现在与其他治疗方式相关方面。正在开发分子策略以预测对已知治疗药物的反应并识别其他药物。此外，多种用于PDAC的新药正在研发中，包括抑制关键分子途径的药物、试图利用同源修复缺陷的药物、免疫治疗方法、抗代谢药物以及攻击支持PDAC生长的细胞外基质的药物。这些新方法为未来的PDAC患者带来了提高生存率的希望。
