Abstract
While significant advances have been made in the treatment of many different solid tumors, pancreatic cancer remains a glaring exception. Overall 5-year survival rates for pancreatic cancer remain in the single digits. While newer chemotherapy regimens such as FOLFIRINOX and nab-paclitaxel/gemcitabine have demonstrated modest improvement in survival benefit for metastatic disease and have improved the resectability rates of previously borderline or locally advanced tumors, clinically significant improvements from immunotherapy and targeted therapy remain to be demonstrated. Regardless, a wealth of basic science research in pancreatic cancer has been directed at understanding its aggressive biology and its resistance to therapy. We present a brief summary of key areas of laboratory research and its translation to clinical care.
Highlights
In the past two decades, there have been significant advances in the treatment of different cancer types, with the exploding field of targeted therapy and immunotherapy
While immunotherapy is at the forefront of translational research efforts, other key areas of interest include targeted therapies against tumor cells and the extracellular matrix, pathogenesis of pancreatic cancer, and methods of early detection
Known precursors to pancreatic cancer, such as pancreatic intraepithelial neoplasia (Pan-IN) and intraductal mucinous papillary neoplasm (IPMN), virtually all harbor gene mutations [21, 22]. These findings may help direct biomarker detection for diagnosis for those precursor lesions that may progress to invasive adenocarcinoma
Summary
In the past two decades, there have been significant advances in the treatment of different cancer types, with the exploding field of targeted therapy and immunotherapy. Pancreatic tumors are immune-quiescent, and single-agent immunotherapies have failed to show a significant clinical response [1,2,3,4]. This is due in part to a tumor microenvironment, characterized by a dense desmoplastic stroma, which demonstrates high inflammatory cell expression and limits intratumoral infiltration with effector T cells [5,6,7,8]. While immunotherapy is at the forefront of translational research efforts, other key areas of interest include targeted therapies against tumor cells and the extracellular matrix, pathogenesis of pancreatic cancer, and methods of early detection. We outline the trends in translational research in pancreatic cancer with respect to these elements
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