Tirpe Alexandru, Streianu Cristian, Isachesku Ekaterina, Simon Ioan, Berindan-Neagoe Ioana
Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 23 Marinescu Street, 400337, Cluj-Napoca, Romania.
The Oncology Institute "Prof. Dr. Ion Chiricuta", 34-36 Republicii Street, 400015 Cluj-Napoca, Romania.
Heliyon. 2024 Sep 19;10(19):e38196. doi: 10.1016/j.heliyon.2024.e38196. eCollection 2024 Oct 15.
Pancreatic cancer (PC) is an intricate malignancy with poor prognosis. In the present state of the art review paper and clinical trial trend analysis, we explore the current clinically employed state of pancreatic cancer body of knowledge and future research directions. When considering PDACs' molecular biology, we underline the role of PanIN in carcinogenesis and mutational gain, as well as the distinctive tumor microenvironment with the characteristic dense fibrotic stroma. The mutational landscape of PC typically involves KRAS, TP53, SMAD4 and CDKN2A genes, but other mutations can be identified depending on the PDAC subtype. Due to various factors, there are currently limited therapeutic options - from a surgical-centered approach in the resectable stage, to a systemic approach in more advanced stages, including the potential applicability of personalized medicine. Currently, there are numerous clinical trials undergoing that study various landscapes - from the use of newer or repurposed chemotherapeutics, to the introduction of newer immunotherapeutic agents, antibody-drug conjugates, TCR-T cell therapy and the study of mDC3/8-KRAS cancer vaccines, among others.
胰腺癌（PC）是一种预后较差的复杂恶性肿瘤。在当前的前沿综述文章和临床试验趋势分析中，我们探讨了胰腺癌现有知识的临床应用现状以及未来的研究方向。在考虑胰腺导管腺癌（PDAC）的分子生物学时，我们强调胰腺上皮内瘤变（PanIN）在致癌作用和突变增加中的作用，以及具有特征性致密纤维化基质的独特肿瘤微环境。PC的突变图谱通常涉及KRAS、TP53、SMAD4和CDKN2A基因，但根据PDAC亚型还可发现其他突变。由于各种因素，目前治疗选择有限——从可切除阶段以手术为主的方法，到更晚期的全身治疗方法，包括个性化医疗的潜在适用性。目前，有许多正在进行的临床试验，研究各种领域——从使用更新的或重新利用的化疗药物，到引入更新的免疫治疗药物、抗体药物偶联物、TCR-T细胞疗法以及mDC3/8-KRAS癌症疫苗的研究等等。
