The Current Treatment Paradigm for Pancreatic Ductal Adenocarcinoma and Barriers to Therapeutic Efficacy

Pancreatic ductal adenocarcinoma (PDAC) has a dismal prognosis, with a median survival time of 10-12 months. Clinically, these poor outcomes are attributed to several factors, including late stage at the time of diagnosis impeding resectability, as well as multi-drug resistance. Despite the high pre...

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Bibliographic Details
Published inFrontiers in oncology Vol. 11; p. 688377
Main Authors Principe, Daniel R, Underwood, Patrick W, Korc, Murray, Trevino, Jose G, Munshi, Hidayatullah G, Rana, Ajay
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 15.07.2021
Subjects
chemotherapy
immunotherapy
Oncology
pancreatic cancer
radiation
surgery
targeted therapy
targeted therapy
treatment
pancreatic cancer
radiation
immunotherapy
chemotherapy
surgery
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Summary:Pancreatic ductal adenocarcinoma (PDAC) has a dismal prognosis, with a median survival time of 10-12 months. Clinically, these poor outcomes are attributed to several factors, including late stage at the time of diagnosis impeding resectability, as well as multi-drug resistance. Despite the high prevalence of drug-resistant phenotypes, nearly all patients are offered chemotherapy leading to modest improvements in postoperative survival. However, chemotherapy is all too often associated with toxicity, and many patients elect for palliative care. In cases of inoperable disease, cytotoxic therapies are less efficacious but still carry the same risk of serious adverse effects, and clinical outcomes remain particularly poor. Here we discuss the current state of pancreatic cancer therapy, both surgical and medical, and emerging factors limiting the efficacy of both. Combined, this review highlights an unmet clinical need to improve our understanding of the mechanisms underlying the poor therapeutic responses seen in patients with PDAC, in hopes of increasing drug efficacy, extending patient survival, and improving quality of life.
Bibliography:Reviewed by: Savio George Barreto, Medanta The Medicity Hospital, India; Mariacristina Di Marco, University of Bologna, Italy; Milly Buwenge, University of Bologna, Italy
Edited by: Alessio G. Morganti, University of Bologna, Italy
These authors share first authorship
This article was submitted to Gastrointestinal Cancers, a section of the journal Frontiers in Oncology
ISSN:2234-943X
2234-943X
DOI:10.3389/fonc.2021.688377