New Diagnostic and Therapeutic Aspects of Pancreatic Ductal Adenocarcinoma.

Citation data:

Current medicinal chemistry, ISSN: 1875-533X, Vol: 24, Issue: 28, Page: 3012-3024

Publication Year:
2017
Usage 3
Abstract Views 3
Captures 8
Readers 8
Social Media 1
Tweets 1
PMID:
28494747
DOI:
10.2174/0929867324666170510150124
Author(s):
Mangge, Harald; Niedrist, Tobias; Renner, Wilfried; Lyer, Stefan; Alexiou, Christoph; Haybaeck, Johannes
Publisher(s):
Bentham Science Publishers Ltd.
Tags:
Biochemistry, Genetics and Molecular Biology; Pharmacology, Toxicology and Pharmaceutics
Most Recent Tweet View All Tweets
review description
Pancreatic ductal adenocarcinoma (PDAC) is devastating. Because of its silent nature, the disease is often only diagnosed once it has reached an advanced, frequently inoperable stage. To date, we have no biomarkers that facilitate earlier diagnosis, leaving sufficient time for curative therapy that effectively lowers the very high mortality rate of this cancer entity. Because of this, the life expectancy of patients with PDAC is low (i.e. ≤ 6% five-year survival rates). New data, including particular genetic signatures and features of the stromal architecture of PDAC tumors, may better explain their aggressiveness, their relatively long-lasting painless expansion, and why chemotherapy so frequently fails. The typical tumor-induced stromal desmoplasia is characterized by cancer-associated fibroblasts (CAFs), decreased immune surveillance, cancer-associated neural remodeling, and a very low vascular density. This stromal microenvironment generates hypoxia, nutrient deficiency, immune suppression, and chemoresistance. The combination of factors results in a vicious disease that begins with the long-lasting, asymptomatic development of a large tumor mass, followed by a delayed diagnosis with a high percentage of inoperable states, exhibiting a poor response to all conservative therapeutic options, including radiation, and which ends with metastasis resulting in a rapid fatal outcome.