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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

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
Aspirin Use and Risk of Pancreatic Ductal Adenocarcinoma: A Large Case-Control Study.
Momayez Sanat Z, Masoudi S, Tabaeian SP, Jameh Shorani M, Soruri M, Pourshams A
Arch Iran Med 2023 Apr 1;26(4):181-185. doi: 10.34172/aim.2023.28. PMID: 38301077Free PMC Article
Screening and Surveillance for Pancreatic Adenocarcinoma in High-Risk Individuals.
Labiner AJ, Aronson A, Lucas AL
Hematol Oncol Clin North Am 2022 Oct;36(5):929-942. doi: 10.1016/j.hoc.2022.06.004. PMID: 36265991
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

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
CSNK2A1 confers gemcitabine resistance to pancreatic ductal adenocarcinoma via inducing autophagy.
Liu ZD, Shi YH, Xu QC, Zhao GY, Zhu YQ, Li FX, Ma MJ, Ye JY, Huang XT, Wang XY, Xu X, Wang JQ, Zhao W, Yin XY
Cancer Lett 2024 Mar 31;585:216640. Epub 2024 Jan 28 doi: 10.1016/j.canlet.2024.216640. PMID: 38290659
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
Acinar cell plasticity and development of pancreatic ductal adenocarcinoma.
Storz P
Nat Rev Gastroenterol Hepatol 2017 May;14(5):296-304. Epub 2017 Mar 8 doi: 10.1038/nrgastro.2017.12. PMID: 28270694Free PMC Article

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
NALIRIFOX versus nab-paclitaxel and gemcitabine in treatment-naive patients with metastatic pancreatic ductal adenocarcinoma (NAPOLI 3): a randomised, open-label, phase 3 trial.
Wainberg ZA, Melisi D, Macarulla T, Pazo Cid R, Chandana SR, De La Fouchardière C, Dean A, Kiss I, Lee WJ, Goetze TO, Van Cutsem E, Paulson AS, Bekaii-Saab T, Pant S, Hubner RA, Xiao Z, Chen H, Benzaghou F, O'Reilly EM
Lancet 2023 Oct 7;402(10409):1272-1281. Epub 2023 Sep 11 doi: 10.1016/S0140-6736(23)01366-1. PMID: 37708904Free PMC Article
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
NAPOLI-1 phase 3 study of liposomal irinotecan in metastatic pancreatic cancer: Final overall survival analysis and characteristics of long-term survivors.
Wang-Gillam A, Hubner RA, Siveke JT, Von Hoff DD, Belanger B, de Jong FA, Mirakhur B, Chen LT
Eur J Cancer 2019 Feb;108:78-87. Epub 2019 Jan 14 doi: 10.1016/j.ejca.2018.12.007. PMID: 30654298

Prognosis

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
Advances in the management of pancreatic ductal adenocarcinoma.
O'Kane GM, Ladak F, Gallinger S
CMAJ 2021 Jun 7;193(23):E844-E851. doi: 10.1503/cmaj.201450. PMID: 34099468Free PMC Article
ASO Author Reflections: Margin-Positive Pancreatic Ductal Adenocarcinoma During Pancreaticoduodenectomy: Additional Resection Does Not Improve Survival.
Zheng R, Nauheim D, Bassig J, Chadwick M, Schultz CW, Krampitz G, Lavu H, Winter JR, Yeo CJ, Berger AC
Ann Surg Oncol 2020 Dec;27(Suppl 3):895-896. Epub 2020 Aug 19 doi: 10.1245/s10434-020-09031-2. PMID: 32813199
PEGPH20 for metastatic pancreatic ductal adenocarcinoma.
Gourd E
Lancet Oncol 2018 Feb;19(2):e81. Epub 2017 Dec 21 doi: 10.1016/S1470-2045(17)30953-1. PMID: 29276021
Multidisciplinary management of locally advanced pancreatic ductal adenocarcinoma.
Alemi F, Alseidi A, Scott Helton W, Rocha FG
Curr Probl Surg 2015 Sep;52(9):362-98. Epub 2015 Jul 17 doi: 10.1067/j.cpsurg.2015.07.003. PMID: 26363649

Clinical prediction guides

Transcriptomic-Based Microenvironment Classification Reveals Precision Medicine Strategies for Pancreatic Ductal Adenocarcinoma.
George B, Kudryashova O, Kravets A, Thalji S, Malarkannan S, Kurzrock R, Chernyavskaya E, Gusakova M, Kravchenko D, Tychinin D, Savin E, Alekseeva L, Butusova A, Bagaev A, Shin N, Brown JH, Sethi I, Wang D, Taylor B, McFall T, Kamgar M, Hall WA, Erickson B, Christians KK, Evans DB, Tsai S
Gastroenterology 2024 May;166(5):859-871.e3. Epub 2024 Jan 25 doi: 10.1053/j.gastro.2024.01.028. PMID: 38280684
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
Protein biomarker for pancreatic ductal adenocarcinoma.
Burki T
Lancet Oncol 2017 Sep;18(9):e511. Epub 2017 Jul 20 doi: 10.1016/S1470-2045(17)30564-8. PMID: 28736187
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

Comparison of first-line chemotherapy regimens in unresectable locally advanced or metastatic pancreatic cancer: a systematic review and Bayesian network meta-analysis.
Mastrantoni L, Chiaravalli M, Spring A, Beccia V, Di Bello A, Bagalà C, Bensi M, Barone D, Trovato G, Caira G, Giordano G, Bria E, Tortora G, Salvatore L
Lancet Oncol 2024 Dec;25(12):1655-1665. Epub 2024 Nov 11 doi: 10.1016/S1470-2045(24)00511-4. PMID: 39542008
Gut microbiome changes associated with chronic pancreatitis and pancreatic cancer: a systematic review and meta-analysis.
Hong J, Fu Y, Chen X, Zhang Y, Li X, Li T, Liu Y, Fan M, Lin R
Int J Surg 2024 Sep 1;110(9):5781-5794. doi: 10.1097/JS9.0000000000001724. PMID: 38847785Free PMC Article
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
Risk of pancreatic ductal adenocarcinoma associated with carriage of BRCA1 and/or BRCA2 mutation: A systematic review and meta-analysis.
McGarry JL, Creavin B, Kelly ME, Gallagher TK
J Surg Oncol 2022 Nov;126(6):1028-1037. Epub 2022 Jun 30 doi: 10.1002/jso.26994. PMID: 35770919
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

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