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Pancreatic ductal adenocarcinoma

MedGen UID:
277490
•Concept ID:
C1335302
•
Neoplastic Process
Synonym: Pancreatic tubular adenocarcinoma
SNOMED CT: Pancreatic ductal adenocarcinoma (792907004); Ductal adenocarcinoma of pancreas (792907004); Adenocarcinoma of pancreatic duct (792907004); PDAC - pancreatic ductal adenocarcinoma (792907004)
 
Monarch Initiative: MONDO:0005184

Definition

An infiltrating adenocarcinoma that arises from the epithelial cells of the pancreas. It affects males more often than females and the patients are usually over 50 years of age. Microscopically it is characterized by the presence of glandular (ductal) differentiation and desmoplastic stroma formation. Signs and symptoms include pain, loss of weight, and jaundice. It grows rapidly and is usually detected after it has metastasized to other anatomic sites. The prognosis is usually poor. [from NCI]

Professional guidelines

PubMed

International evidence-based Kyoto guidelines for the management of intraductal papillary mucinous neoplasm of the pancreas.
Ohtsuka T, Fernandez-Del Castillo C, Furukawa T, Hijioka S, Jang JY, Lennon AM, Miyasaka Y, Ohno E, Salvia R, Wolfgang CL, Wood LD
Pancreatology 2024 Mar;24(2):255-270. Epub 2023 Dec 28 doi: 10.1016/j.pan.2023.12.009. PMID: 38182527
Single-nucleus and spatial transcriptome profiling of pancreatic cancer identifies multicellular dynamics associated with neoadjuvant treatment.
Hwang WL, Jagadeesh KA, Guo JA, Hoffman HI, Yadollahpour P, Reeves JW, Mohan R, Drokhlyansky E, Van Wittenberghe N, Ashenberg O, Farhi SL, Schapiro D, Divakar P, Miller E, Zollinger DR, Eng G, Schenkel JM, Su J, Shiau C, Yu P, Freed-Pastor WA, Abbondanza D, Mehta A, Gould J, Lambden C, Porter CBM, Tsankov A, Dionne D, Waldman J, Cuoco MS, Nguyen L, Delorey T, Phillips D, Barth JL, Kem M, Rodrigues C, Ciprani D, Roldan J, Zelga P, Jorgji V, Chen JH, Ely Z, Zhao D, Fuhrman K, Fropf R, Beechem JM, Loeffler JS, Ryan DP, Weekes CD, Ferrone CR, Qadan M, Aryee MJ, Jain RK, Neuberg DS, Wo JY, Hong TS, Xavier R, Aguirre AJ, Rozenblatt-Rosen O, Mino-Kenudson M, Castillo CF, Liss AS, Ting DT, Jacks T, Regev A
Nat Genet 2022 Aug;54(8):1178-1191. Epub 2022 Jul 28 doi: 10.1038/s41588-022-01134-8. PMID: 35902743Free PMC Article
Pancreatic Cancer: Pathogenesis, Screening, Diagnosis, and Treatment.
Wood LD, Canto MI, Jaffee EM, Simeone DM
Gastroenterology 2022 Aug;163(2):386-402.e1. Epub 2022 Apr 7 doi: 10.1053/j.gastro.2022.03.056. PMID: 35398344Free PMC Article

Recent clinical studies

Etiology

Pancreatic Cancer and Venous Thromboembolism.
Prouse T, Mohammad MA, Ghosh S, Kumar N, Duhaylungsod ML, Majumder R, Majumder S
Int J Mol Sci 2024 May 23;25(11) doi: 10.3390/ijms25115661. PMID: 38891849Free PMC Article
Early detection of pancreatic cancer in the era of precision medicine.
Ahmed TM, Kawamoto S, Lopez-Ramirez F, Yasrab M, Hruban RH, Fishman EK, Chu LC
Abdom Radiol (NY) 2024 Oct;49(10):3559-3573. Epub 2024 May 18 doi: 10.1007/s00261-024-04358-w. PMID: 38761272
Pancreatic Cancer: Pathogenesis, Screening, Diagnosis, and Treatment.
Wood LD, Canto MI, Jaffee EM, Simeone DM
Gastroenterology 2022 Aug;163(2):386-402.e1. Epub 2022 Apr 7 doi: 10.1053/j.gastro.2022.03.056. PMID: 35398344Free PMC Article
Contemporary Management of Pancreatic Cancer from an Internist Perspective.
Sipra QUAR, Islam M, Riaz IB, Zhaohui J, Babiker HM, Bekaii-Saab TS, Sonbol MB
Am J Med 2021 May;134(5):576-586. Epub 2020 Dec 11 doi: 10.1016/j.amjmed.2020.11.009. PMID: 33316248
Imaging and Screening of Pancreatic Cancer.
Burk KS, Lo GC, Gee MS, Sahani DV
Radiol Clin North Am 2017 Nov;55(6):1223-1234. doi: 10.1016/j.rcl.2017.06.006. PMID: 28991562

Diagnosis

Roles of microbiota in pancreatic cancer development and treatment.
Cruz MS, Tintelnot J, Gagliani N
Gut Microbes 2024 Jan-Dec;16(1):2320280. Epub 2024 Feb 27 doi: 10.1080/19490976.2024.2320280. PMID: 38411395Free PMC Article
Predictive value of collagen in cancer.
Angel PM, Zambrzycki SC
Adv Cancer Res 2022;154:15-45. Epub 2022 Mar 18 doi: 10.1016/bs.acr.2022.02.004. PMID: 35459468
Pancreatic Cancer: Pathogenesis, Screening, Diagnosis, and Treatment.
Wood LD, Canto MI, Jaffee EM, Simeone DM
Gastroenterology 2022 Aug;163(2):386-402.e1. Epub 2022 Apr 7 doi: 10.1053/j.gastro.2022.03.056. PMID: 35398344Free PMC Article
Imaging and Screening of Pancreatic Cancer.
Burk KS, Lo GC, Gee MS, Sahani DV
Radiol Clin North Am 2017 Nov;55(6):1223-1234. doi: 10.1016/j.rcl.2017.06.006. PMID: 28991562
Adjuvant treatment for pancreatic ductal carcinoma.
Macarulla T, Fernández T, Gallardo ME, Hernando O, López AM, Hidalgo M
Clin Transl Oncol 2017 Oct;19(10):1199-1204. Epub 2017 Jun 21 doi: 10.1007/s12094-017-1683-5. PMID: 28639051

Therapy

Therapeutic developments in pancreatic cancer.
Hu ZI, O'Reilly EM
Nat Rev Gastroenterol Hepatol 2024 Jan;21(1):7-24. Epub 2023 Oct 5 doi: 10.1038/s41575-023-00840-w. PMID: 37798442
Precision Medicine and Pancreatic Cancer.
George B
Surg Oncol Clin N Am 2021 Oct;30(4):693-708. doi: 10.1016/j.soc.2021.06.008. PMID: 34511190
Emerging Treatment Strategies in Pancreatic Cancer.
Trunk A, Miotke L, Nevala-Plagemann C, Verdaguer H, Macarulla T, Garrido-Laguna I
Pancreas 2021 Jul 1;50(6):773-787. doi: 10.1097/MPA.0000000000001845. PMID: 34398070
Molecular alterations and targeted therapy in pancreatic ductal adenocarcinoma.
Qian Y, Gong Y, Fan Z, Luo G, Huang Q, Deng S, Cheng H, Jin K, Ni Q, Yu X, Liu C
J Hematol Oncol 2020 Oct 2;13(1):130. doi: 10.1186/s13045-020-00958-3. PMID: 33008426Free PMC Article
Challenges and Opportunities for Pancreatic Cancer Immunotherapy.
Bear AS, Vonderheide RH, O'Hara MH
Cancer Cell 2020 Dec 14;38(6):788-802. Epub 2020 Sep 17 doi: 10.1016/j.ccell.2020.08.004. PMID: 32946773Free PMC Article

Prognosis

Emerging Therapeutic Options in Pancreatic Cancer Management.
Delle Cave D
Int J Mol Sci 2024 Feb 5;25(3) doi: 10.3390/ijms25031929. PMID: 38339207Free PMC Article
The Impact of Molecular Subtyping on Pathological Staging of Pancreatic Cancer.
Dreyer SB, Rae S, Bisset K, Upstill-Goddard R, Gemenetzis G, Johns AL, Dickson EJ, Mittal A, Gill AJ, Duthie F, Pea A, Lawlor RT, Scarpa A, Salvia R, Pulvirenti A, Zerbi A, Marchesi F, McKay CJ, Biankin AV, Samra JS, Chang DK, Jamieson NB; Australian Pancreatic Cancer Genome Initiative; Glasgow Precision Oncology Laboratory
Ann Surg 2023 Feb 1;277(2):e396-e405. Epub 2023 Jan 10 doi: 10.1097/SLA.0000000000005050. PMID: 36745763Free PMC Article
Pancreatic cancer: A review of epidemiology, trend, and risk factors.
Hu JX, Zhao CF, Chen WB, Liu QC, Li QW, Lin YY, Gao F
World J Gastroenterol 2021 Jul 21;27(27):4298-4321. doi: 10.3748/wjg.v27.i27.4298. PMID: 34366606Free PMC Article
Impact of Immunotherapy after Resection of Pancreatic Cancer.
Tran TB, Maker VK, Maker AV
J Am Coll Surg 2019 Jul;229(1):19-27.e1. Epub 2019 Feb 10 doi: 10.1016/j.jamcollsurg.2019.01.016. PMID: 30742911Free PMC Article
Pancreaticoduodenectomy with vascular resection for pancreatic head adenocarcinoma.
Liles JS, Katz MH
Expert Rev Anticancer Ther 2014 Aug;14(8):919-29. Epub 2014 May 16 doi: 10.1586/14737140.2014.919860. PMID: 24833085

Clinical prediction guides

Predicting Pancreatic Cancer in the UK Biobank Cohort Using Polygenic Risk Scores and Diabetes Mellitus.
Sharma S, Tapper WJ, Collins A, Hamady ZZR
Gastroenterology 2022 May;162(6):1665-1674.e2. Epub 2022 Jan 21 doi: 10.1053/j.gastro.2022.01.016. PMID: 35065983
Development and Verification of the Hypoxia- and Immune-Associated Prognostic Signature for Pancreatic Ductal Adenocarcinoma.
Chen D, Huang H, Zang L, Gao W, Zhu H, Yu X
Front Immunol 2021;12:728062. Epub 2021 Oct 6 doi: 10.3389/fimmu.2021.728062. PMID: 34691034Free PMC Article
Early Detection of Pancreatic Cancer: Opportunities and Challenges.
Singhi AD, Koay EJ, Chari ST, Maitra A
Gastroenterology 2019 May;156(7):2024-2040. Epub 2019 Feb 2 doi: 10.1053/j.gastro.2019.01.259. PMID: 30721664Free PMC Article
Significance of pathological positive superior mesenteric/portal venous invasion in pancreatic cancer.
Tewari M
Hepatobiliary Pancreat Dis Int 2016 Dec;15(6):572-578. doi: 10.1016/s1499-3872(16)60156-x. PMID: 27919845
The importance of surgical margins in pancreatic cancer.
Ethun CG, Kooby DA
J Surg Oncol 2016 Mar;113(3):283-8. Epub 2015 Nov 25 doi: 10.1002/jso.24092. PMID: 26603829

Recent systematic reviews

NALIRIFOX, FOLFIRINOX, and Gemcitabine With Nab-Paclitaxel as First-Line Chemotherapy for Metastatic Pancreatic Cancer: A Systematic Review and Meta-Analysis.
Nichetti F, Rota S, Ambrosini P, Pircher C, Gusmaroli E, Droz Dit Busset M, Pusceddu S, Sposito C, Coppa J, Morano F, Pietrantonio F, Di Bartolomeo M, Mariani L, Mazzaferro V, de Braud F, Niger M
JAMA Netw Open 2024 Jan 2;7(1):e2350756. doi: 10.1001/jamanetworkopen.2023.50756. PMID: 38190183Free PMC Article
Modulation of pancreatic cancer cell sensitivity to FOLFIRINOX through microRNA-mediated regulation of DNA damage.
Carotenuto P, Amato F, Lampis A, Rae C, Hedayat S, Previdi MC, Zito D, Raj M, Guzzardo V, Sclafani F, Lanese A, Parisi C, Vicentini C, Said-Huntingford I, Hahne JC, Hallsworth A, Kirkin V, Young K, Begum R, Wotherspoon A, Kouvelakis K, Azevedo SX, Michalarea V, Upstill-Goddard R, Rao S, Watkins D, Starling N, Sadanandam A, Chang DK, Biankin AV, Jamieson NB, Scarpa A, Cunningham D, Chau I, Workman P, Fassan M, Valeri N, Braconi C
Nat Commun 2021 Nov 18;12(1):6738. doi: 10.1038/s41467-021-27099-6. PMID: 34795259Free PMC Article
The role of FDG PET/CT or PET/MRI in assessing response to neoadjuvant therapy for patients with borderline or resectable pancreatic cancer: a systematic literature review.
Evangelista L, Zucchetta P, Moletta L, Serafini S, Cassarino G, Pegoraro N, Bergamo F, Sperti C, Cecchin D
Ann Nucl Med 2021 Jul;35(7):767-776. Epub 2021 May 28 doi: 10.1007/s12149-021-01629-0. PMID: 34047926Free PMC Article
A systematic review into patient reported outcomes following pancreaticoduodenectomy for malignancy.
Patel BY, White L, Gavriilidis P, Satyadas T, Frampton AE, Pai M
Eur J Surg Oncol 2021 May;47(5):970-978. Epub 2020 Dec 8 doi: 10.1016/j.ejso.2020.11.146. PMID: 33339639
Targeting DNA repair in combination with radiotherapy in pancreatic cancer: A systematic review of preclinical studies.
Waissi W, Paix A, Nicol A, Noël G, Burckel H
Crit Rev Oncol Hematol 2020 Sep;153:103060. Epub 2020 Jul 11 doi: 10.1016/j.critrevonc.2020.103060. PMID: 32707435

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