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胰腺癌:当前概念、趋势与未来方向

Pancreatic Cancer: Current Concepts, Trends, and Future Directions.

作者信息

Wenzel Patrick, Mogler Carolin, Görgülü Kıvanç, Algül Hana

机构信息

Comprehensive Cancer Center Munich TUM, TUM University Hospital, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.

Internal Medicine II, TUM University Hospital, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.

出版信息

Turk J Gastroenterol. 2024 Nov 18;36(2):69-81. doi: 10.5152/tjg.2024.24544.

Abstract

Pancreatic ductal adenocarcinoma (PC) ranks among the deadliest cancers, with a less than 15% 5-year survival rate. Epidemiological studies project that it will become the second leading cause of cancer-associated mortalities in the following decades. The hallmarks of pancreatic cancer lead to tumor aggressiveness and therapeutic resistance. For this reason, the field has been focusing on multiple dimensions to generate better therapeutic approaches, including new adjuvant, neoadjuvant, and palliative concepts to extend the survival of PC patients. Over the last 2 decades, clinical trials have significantly improved disease prognosis and patient survival. To achieve better outcomes and to deeply understand the therapeutic approaches, molecular tumor boards have become crucial for deeper exploitation of tumor genetics and tumor biology, providing better stratification markers for therapeutic regimens. Using recently developed targeted therapies, such as KRAS inhibitors, the field has gathered momentum and been tooled up with the help of new sequencing technologies. Therefore, researchers and clinicians have geared up for the battle against PC. This review will systematically discuss recent developments in adjuvant, neoadjuvant, and palliative treatment modalities. Moreover, the paradigm-shifting importance of genetic profiling on pancreatic cancer. will be explained through a showcase to frame future directions.

摘要

胰腺导管腺癌(PC)是最致命的癌症之一,5年生存率不到15%。流行病学研究预测,在接下来的几十年里,它将成为癌症相关死亡的第二大主要原因。胰腺癌的特征导致肿瘤侵袭性和治疗抵抗性。因此,该领域一直专注于多个维度以产生更好的治疗方法,包括新的辅助、新辅助和姑息治疗理念,以延长PC患者的生存期。在过去20年里,临床试验显著改善了疾病预后和患者生存率。为了取得更好的结果并深入了解治疗方法,分子肿瘤委员会对于更深入地探索肿瘤遗传学和肿瘤生物学变得至关重要,为治疗方案提供更好的分层标志物。利用最近开发的靶向疗法,如KRAS抑制剂,该领域借助新的测序技术获得了动力并配备了工具。因此,研究人员和临床医生已经为对抗PC做好了准备。本综述将系统地讨论辅助、新辅助和姑息治疗方式的最新进展。此外将通过一个案例展示来解释基因谱分析对胰腺癌的范式转变重要性,以规划未来方向。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/677d/11843265/8ddd4f0107ff/tjg-36-2-69_f001.jpg

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