Evolving pancreatic cancer treatment: From diagnosis to healthcare management. (January 2022)

• Record Type: Journal Article
• Authors: Milella, Michele; Bassi, Claudio; Boggi, Ugo; Brunetti, Oronzo; Cavaliere, Alessandro; Crippa, Stefano; De Vita, Ferdinando; Falconi, Massimo; Frassineti, Giovanni Luca; Giommoni, Elisa; Macchini, Marina; Malleo, Giuseppe; Silvestris, Nicola; Tudisco, Antonella; Vasile, Enrico; Reni, Michele
• Is Part Of: Critical reviews in oncology/hematology. Volume 169(2022)
• Publication Date: 2022-01
• Subjects: PDAC Pancreatic ductal adenocarcinoma -- PROs Patient-reported outcomes -- NAC Neo-adjuvant chemotherapy -- LAPC Locally advanced pancreatic cancer -- BRPC Borderline resectable pancreatic cancer; Pancreatic ductal adenocarcinoma -- Adjuvant chemotherapy -- Neoadjuvant chemotherapy -- Patient-reported outcomes -- Healthcare management -- Locally advanced pancreatic cancer -- Borderline Resectable pancreatic cancer; Oncology -- Periodicals; Hematology -- Periodicals; 616.994
• DOI: 10.1016/j.critrevonc.2021.103571
• Languages: English
• ISSNs: 1040-8428

Abstract

Graphical abstract: Highlights: Pancreatic ductal adenocarcinoma (PDAC) prognosis is still one the worst among solid tumors. Multimodality care and molecular-driven drugs have shown a trend for improvement, albeit limited, in the disease control. New insights in PDAC diagnosis, medical and surgical treatments and healthcare management are discussed here by a panel of experts. Abstract: The prognosis of pancreatic ductal adenocarcinoma is still the worst among solid tumors. In this review, a panel of experts addressed the main unanswered questions about the clinical management of this disease, with the aim of providing practical decision support for physicians. On the basis of the evidence available from the literature, the main topics concerning pancreatic cancer are discussed: the diagnosis, as the need for a pathological characterization and the role for germ-line and somatic molecular profiling; the therapeutic management of resectable disease, as the role of upfront surgery or neoadjuvant chemotherapy, the post-operative restaging and the optimal timing foradjuvant chemotherapy, the management of the borderline resectable and locally advanced disease; the metastatic disease and the role of surgery for the management of patients with isolated metastasis and the use of biomarkers of metastatic potential; the role of supportive care and the healthcare management of pancreatic ductal adenocarcinoma.