title: Pancreatic cancer: advances in treatment.
abstract: Pancreatic cancer is a leading cause of cancer mortality and the incidence of this disease is expected to continue increasing. While patients with pancreatic cancer have traditionally faced a dismal prognosis, over the past several years various advances in diagnosis and treatment have begun to positively impact this disease. Identification of effective combinations of existing chemotherapeutic agents, such as the FOLFIRINOX and the gemcitabine + nab-paclitaxel regimen, has improved survival for selected patients although concerns regarding their toxicity profiles remain. A better understanding of pancreatic carcinogenesis has identified several pre-malignant precursor lesions, such as pancreatic intraepithelial neoplasias, intraductal papillary mucinous neoplasms, and cystic neoplasms. Imaging technology has also evolved dramatically so as to allow early detection of these lesions and thereby facilitate earlier management. Surgery remains a cornerstone of treatment for patients with resectable pancreatic tumors, and advances in surgical technique have allowed patients to undergo resection with decreasing perioperative morbidity and mortality. Surgery has also become feasible in selected patients with borderline resectable tumors as a result of neoadjuvant therapy. Furthermore, pancreatectomy involving vascular reconstruction and pancreatectomy with minimally invasive techniques have demonstrated safety without significantly compromising oncologic outcomes. Lastly, a deeper understanding of molecular aberrations contributing to the development of pancreatic cancer shows promise for future development of more targeted and safe therapeutic agents.
authors: Somala Mohammed, George Van Buren II, William E Fisher, The Elkins Pancreas Center, Michael E DeBakey Department of Surgery, and Dan L Duncan Cancer Center, Baylor College of Medicine, Houston, TX 77030, United States.
authors: Somala
authors: S
authors: Mohammed
authors: Somala Mohammed, George Van Buren II, William E Fisher, The Elkins Pancreas Center, Michael E DeBakey Department of Surgery, and Dan L Duncan Cancer Center, Baylor College of Medicine, Houston, TX 77030, United States.
authors: George
authors: G
authors: Van Buren
authors: Somala Mohammed, George Van Buren II, William E Fisher, The Elkins Pancreas Center, Michael E DeBakey Department of Surgery, and Dan L Duncan Cancer Center, Baylor College of Medicine, Houston, TX 77030, United States.
authors: William E
authors: WE
authors: Fisher
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D055088:Early Detection of Cancer / Q000639:trends; D005762:Gastroenterology / Q000639:trends*; D006801:Humans; D008495:Medical Oncology / Q000639:trends*; D025202:Molecular Diagnostic Techniques / Q000639:trends; D058990:Molecular Targeted Therapy / Q000639:trends; D020360:Neoadjuvant Therapy / Q000639:trends; D010180:Pancreatectomy / Q000009:adverse effects / Q000401:mortality / Q000639:trends*; D010190:Pancreatic Neoplasms / Q000235:genetics / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018579:Patient Selection; D011230:Precancerous Conditions / Q000235:genetics / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D057285:Precision Medicine / Q000639:trends; D011237:Predictive Value of Tests; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Chemotherapy; FOLFIRINOX; Pancreatic cancer; Pancreatic oncology; Pancreatic resection; Pancreaticoduodenectomy; Treatment advances