Addressing the challenges of pancreatic cancer: Future directions for improving outcomes

被引:391
作者
Hidalgo, Manuel [1 ]
Cascinu, Stefano [2 ]
Kleeff, Jorg [3 ]
Labianca, Roberto [4 ]
Lohr, J. -Matthias [5 ]
Neoptolemos, John [6 ,7 ,8 ]
Real, Francisco X. [9 ]
Van Laethem, Jean-Luc [10 ]
Heinemann, Volker [11 ]
机构
[1] CNIO, E-28029 Madrid, Spain
[2] Univ Ancona, Dept Med Oncol, Ancona, Italy
[3] Tech Univ Munich, Dept Gen Surg, D-80290 Munich, Germany
[4] Osped Papa Giovanni XXIII, Bergamo, Italy
[5] Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden
[6] Univ Liverpool, Natl Inst Hlth Res Liverpool, Pancreas Biomed Res Unit, Liverpool L69 3BX, Merseyside, England
[7] Univ Liverpool, Canc Res UK Liverpool, Clin Trials Unit Director, Liverpool L69 3BX, Merseyside, England
[8] Royal Liverpool Univ, Liverpool L69 3BX, Merseyside, England
[9] Madrid & Univ Pompeu Fabra, CNIO, Barcelona, Spain
[10] Erasme Univ Hosp, Dept Gastroenterol GI, Canc Unit, B-1070 Brussels, Belgium
[11] Klinikum Univ Munchen, Comprehens Canc Ctr Munich, Munich, Germany
关键词
Management; Pancreas; Pathogenesis; PDAC; Treatment; Outcomes; PHASE-III TRIAL; RANDOMIZED CONTROLLED-TRIAL; PLUS FOLINIC ACID; ADJUVANT CHEMOTHERAPY; DUCTAL ADENOCARCINOMA; CURATIVE RESECTION; ONCOLOGY-GROUP; NAB-PACLITAXEL; EGF RECEPTOR; STEM-CELLS;
D O I
10.1016/j.pan.2014.10.001
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Pancreatic ductal adenocarcinoma (PDAC), which accounts for more than 90% of all pancreatic tumours, is a devastating malignancy with an extremely poor prognosis, as shown by a 1-year survival rate of around 18% for all stages of the disease. The low survival rates associated with PDAC primarily reflect the fact that tumours progress rapidly with few specific symptoms and are thus at an advanced stage at diagnosis in most patients. As a result, there is an urgent need to develop accurate markers of pre-invasive pancreatic neoplasms in order to facilitate prediction of cancer risk and to help diagnose the disease at an earlier stage. However, screening for early diagnosis of prostate cancer remains challenging and identifying a highly accurate, low-cost screening test for early PDAC for use in clinical practice remains an important unmet need. More effective therapies are also crucial in PDAC, since progress in identifying novel therapies has been hampered by the genetic complexity of the disease and treatment remains a major challenge. Presently, the greatest step towards improved treatment efficacy has been made in the field of palliative chemotherapy by introducing FOLFIRINOX (folinic acid, 5-fluorouracil, irinotecan and oxaliplatin) and gemcitabine/nab-paclitaxel. Strategies designed to raise the profile of PDAC in research and clinical practice are a further requirement in order to ensure the best treatment for patients. This article proposes a number of approaches that may help to accelerate progress in treating patients with PDAC, which, in turn, may be expected to improve the quality of life and survival for those suffering from this devastating disease. Copyright (C) 2014, IAP and EPC. Published by Elsevier India, a division of Reed Elsevier India Pvt. Ltd. All rights reserved.
引用
收藏
页码:8 / 18
页数:11
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