Pancreatic Cancer: Current Multimodality Treatment Options and the Future Impact of Molecular Biological Profiling.
Molecular profiling
Multimodal therapy
Pancreatic cancer
Targeted therapy
Journal
Visceral medicine
ISSN: 2297-4725
Titre abrégé: Visc Med
Pays: Switzerland
ID NLM: 101681546
Informations de publication
Date de publication:
Feb 2022
Feb 2022
Historique:
received:
04
08
2021
accepted:
19
12
2021
entrez:
17
3
2022
pubmed:
18
3
2022
medline:
18
3
2022
Statut:
ppublish
Résumé
Pancreatic cancer (PDAC) - even if deemed resectable - has still a dismal prognosis and is the seventh leading cause of global cancer-related death with rising incidence worldwide. Surgical resection at best in combination with adjuvant systemic chemotherapy is the only potentially curative treatment. Surgical treatment has substantially improved over the last years with significantly reduced perioperative morbidity and mortality. Even when deemed radiologically resectable, the majority of PDAC is likely to have micrometastases, leaving most PDAC patients with an advanced stage. Recent 5-year overall survival was up to 46% in patients eligible for surgery with intensified adjuvant chemotherapy. Eligible for curative surgery are about one-third of the patients, and only 20% of these patients have the option for cure with surgery and adjuvant chemotherapy. Standards of care in treating PDAC patients include various mostly combinational chemotherapy approaches in the advanced and adjuvant setting. Moreover, first targeted therapies for individualizing treatment, e.g., specific subgroups like BRCA1/2 germline mutated patients, were established lately. Neoadjuvant concepts are currently part of research. This review focuses on current and future multimodal treatment options of PDAC and the impact of molecular profiling for individualizing treatment. State of the art in pancreatic cancer therapy is multimodal and includes novel strategies to allow molecular defined subgroup-specific treatment.
Sections du résumé
Background
UNASSIGNED
Pancreatic cancer (PDAC) - even if deemed resectable - has still a dismal prognosis and is the seventh leading cause of global cancer-related death with rising incidence worldwide.
Summary
UNASSIGNED
Surgical resection at best in combination with adjuvant systemic chemotherapy is the only potentially curative treatment. Surgical treatment has substantially improved over the last years with significantly reduced perioperative morbidity and mortality. Even when deemed radiologically resectable, the majority of PDAC is likely to have micrometastases, leaving most PDAC patients with an advanced stage. Recent 5-year overall survival was up to 46% in patients eligible for surgery with intensified adjuvant chemotherapy. Eligible for curative surgery are about one-third of the patients, and only 20% of these patients have the option for cure with surgery and adjuvant chemotherapy. Standards of care in treating PDAC patients include various mostly combinational chemotherapy approaches in the advanced and adjuvant setting. Moreover, first targeted therapies for individualizing treatment, e.g., specific subgroups like BRCA1/2 germline mutated patients, were established lately. Neoadjuvant concepts are currently part of research. This review focuses on current and future multimodal treatment options of PDAC and the impact of molecular profiling for individualizing treatment.
Key Messages
UNASSIGNED
State of the art in pancreatic cancer therapy is multimodal and includes novel strategies to allow molecular defined subgroup-specific treatment.
Identifiants
pubmed: 35295894
doi: 10.1159/000521631
pii: vis-0038-0020
pmc: PMC8874237
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
20-29Informations de copyright
Copyright © 2022 by S. Karger AG, Basel.
Déclaration de conflit d'intérêts
T.J.E. acted as a consultant or received lecture fees from Bayer, BMS, MSD, Sanofi, Merck Serono, Roche, Servier, and Ipsen outside the submitted work. One of his research projects is supported by Servier. N.S., M.G., F.J.H., and L.P. have no conflicts of interest to declare.
Références
J Clin Oncol. 2009 Apr 10;27(11):1806-13
pubmed: 19273710
BMC Cancer. 2019 Dec 30;19(1):1261
pubmed: 31888547
J Clin Oncol. 2007 May 20;25(15):1960-6
pubmed: 17452677
J Clin Oncol. 2020 Jun 1;38(16):1763-1773
pubmed: 32105518
JAMA Oncol. 2017 Apr 01;3(4):516-522
pubmed: 27978579
J Clin Oncol. 1997 Jun;15(6):2403-13
pubmed: 9196156
CA Cancer J Clin. 2018 Nov;68(6):394-424
pubmed: 30207593
Pract Radiat Oncol. 2019 Sep - Oct;9(5):322-332
pubmed: 31474330
J Clin Oncol. 2013 Jan 1;31(1):23-9
pubmed: 23213101
Genome Med. 2020 Jan 14;12(1):8
pubmed: 31937368
Nat Genet. 2017 Mar;49(3):367-376
pubmed: 28092686
Br J Cancer. 2018 Apr;118(7):947-954
pubmed: 29515256
J Clin Oncol. 2010 Aug 1;28(22):3605-10
pubmed: 20606093
Br J Cancer. 2015 Sep 29;113(7):989-95
pubmed: 26372701
Ann Surg. 2001 Dec;234(6):758-68
pubmed: 11729382
J Clin Oncol. 2016 Nov 10;34(32):3914-3920
pubmed: 27621395
Cancers (Basel). 2021 May 21;13(11):
pubmed: 34064221
HPB (Oxford). 2021 Mar;23(3):323-330
pubmed: 33250330
ESMO Open. 2020;5(1):e000578
pubmed: 33551067
J Clin Oncol. 2017 Feb 10;35(5):515-522
pubmed: 27621388
N Engl J Med. 2020 Sep 24;383(13):1207-1217
pubmed: 32955176
Ann Surg Oncol. 2019 Mar;26(3):772-781
pubmed: 30610560
Pancreatology. 2018 Jan;18(1):2-11
pubmed: 29191513
Jpn J Clin Oncol. 2019 Feb 1;49(2):190-194
pubmed: 30608598
Lancet. 2017 Mar 11;389(10073):1011-1024
pubmed: 28129987
Mol Cancer Ther. 2019 Nov;18(11):1899-1908
pubmed: 31676541
N Engl J Med. 2011 May 12;364(19):1817-25
pubmed: 21561347
Yale J Biol Med. 2016 Dec 23;89(4):575-590
pubmed: 28018146
Nat Rev Drug Discov. 2014 Nov;13(11):828-51
pubmed: 25323927
Nature. 2015 Feb 26;518(7540):495-501
pubmed: 25719666
J Natl Cancer Inst. 2014 Jan;106(1):djt347
pubmed: 24301456
Trials. 2021 Jan 8;22(1):40
pubmed: 33419452
Br J Cancer. 2014 Aug 26;111(5):817-22
pubmed: 24755884
J Natl Compr Canc Netw. 2019 Mar 1;17(3):202-210
pubmed: 30865919
Gut. 2021 Apr;70(4):743-760
pubmed: 32873698
Cell. 2012 Jan 20;148(1-2):362-75
pubmed: 22265421
Hepatogastroenterology. 2004 Mar-Apr;51(56):427-33
pubmed: 15086174
Nature. 2019 Nov;575(7781):217-223
pubmed: 31666701
Gut. 2021 Mar;70(3):606-617
pubmed: 32855305
Lancet. 2016 Feb 6;387(10018):545-557
pubmed: 26615328
PLoS Med. 2010 Apr 20;7(4):e1000267
pubmed: 20422030
J Clin Oncol. 2020 Jan 1;38(1):1-10
pubmed: 31682550
Gut. 2014 Sep;63(9):1481-9
pubmed: 24717934
HPB (Oxford). 2020 Jul;22(7):961-968
pubmed: 32360186
J Clin Oncol. 2014 Aug 10;32(23):2423-9
pubmed: 24982456
Lancet Gastroenterol Hepatol. 2019 Mar;4(3):199-207
pubmed: 30685489
United European Gastroenterol J. 2020 Jun;8(5):594-606
pubmed: 32213029
Surgery. 2014 Jun;155(6):977-88
pubmed: 24856119
Gastroenterology. 2017 Jan;152(1):68-74.e2
pubmed: 27856273
Clin Cancer Res. 2020 Sep 15;26(18):4814-4822
pubmed: 32554514
N Engl J Med. 2019 Jul 25;381(4):317-327
pubmed: 31157963
Sci Rep. 2018 Jun 6;8(1):8666
pubmed: 29875415
Semin Oncol. 2021 Feb;48(1):106-110
pubmed: 33771355
Br J Cancer. 2020 Feb;122(3):333-339
pubmed: 31787751
Ann Surg. 2015 Jan;261(1):12-7
pubmed: 25599322
J Clin Oncol. 2015 Oct 1;33(28):3124-9
pubmed: 25940717
Clin Cancer Res. 2015 Jan 15;21(2):396-404
pubmed: 25348516
Ann Surg. 2020 Jan;271(1):54-66
pubmed: 30973388
Cancer Res. 2006 Feb 1;66(3):1500-8
pubmed: 16452206
Br J Cancer. 2016 Mar 29;114(7):737-43
pubmed: 27022826
Surgery. 2021 May;169(5):1019-1025
pubmed: 33032819
Lancet Oncol. 2016 Jun;17(6):801-810
pubmed: 27160474
Eur J Surg Oncol. 2016 Oct;42(10):1552-60
pubmed: 27570116
BMC Cancer. 2008 Mar 28;8:82
pubmed: 18373843
Cochrane Database Syst Rev. 2016 Feb 16;2:CD006053
pubmed: 26905229
Ann Surg. 2016 Sep;264(3):457-63
pubmed: 27355262
Gut. 2013 May;62(5):751-9
pubmed: 22773551
Ann Surg Oncol. 2016 Dec;23(Suppl 5):969-975
pubmed: 27495282
Radiat Oncol. 2019 Jun 6;14(1):95
pubmed: 31171025
Cancer Res. 2017 Oct 15;77(20):5576-5590
pubmed: 28790064
HPB (Oxford). 2017 Nov;19(11):1001-1007
pubmed: 28838632
N Engl J Med. 2018 Dec 20;379(25):2395-2406
pubmed: 30575490
Transl Gastroenterol Hepatol. 2019 Jun 19;4:46
pubmed: 31304423
Lancet Gastroenterol Hepatol. 2021 Feb;6(2):128-138
pubmed: 33338442
Ther Adv Med Oncol. 2020 Feb 28;12:1758835920905408
pubmed: 32165927
Oncol Res Treat. 2020;43(11):628-636
pubmed: 33099551
J Clin Oncol. 2020 May 1;38(13):1378-1388
pubmed: 31976786
Nat Rev Clin Oncol. 2019 Feb;16(2):81-104
pubmed: 30356138
JAMA Oncol. 2021 May 1;7(5):735-738
pubmed: 33704353
J Pancreat Cancer. 2018 Nov 01;4(1):88-94
pubmed: 30631861
Science. 2017 Jul 28;357(6349):409-413
pubmed: 28596308
N Engl J Med. 2013 Oct 31;369(18):1691-703
pubmed: 24131140
Front Oncol. 2016 Apr 25;6:99
pubmed: 27200288
HPB (Oxford). 2019 Feb;21(2):219-225
pubmed: 30093144
BMJ Open. 2021 Feb 22;11(2):e047867
pubmed: 33619204