Current and emerging therapeutic strategies in pancreatic cancer: Challenges and opportunities

doi:10.3748/wjg.v27.i39.6572

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Oct 21, 2021; 27(39): 6572-6589
Published online Oct 21, 2021. doi: 10.3748/wjg.v27.i39.6572

Current and emerging therapeutic strategies in pancreatic cancer: Challenges and opportunities

Manish Manrai, T V S V G K Tilak, Saurabh Dawra, Sharad Srivastava, Anupam Singh

Manish Manrai, T V S V G K Tilak, Department of Internal Medicine, Armed Forces Medical College, Pune 411040, Maharashtra, India

Saurabh Dawra, Sharad Srivastava, Department of Internal Medicine, Command Hospital, Pune 411040, Maharashtra, India

Anupam Singh, Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh 160011, India

Author contributions: Manrai M conceptualized the review and with Tilak TVSVGK, Dawra S was involved with resources, formal analysis, data curation, writing, review, and editing; Srivastava S was involved with resources and analysis; Singh A was involved with review and editing.

Conflict-of-interest statement: The authors have no conflict-of-interest for this manuscript.

Corresponding author: Manish Manrai, MBBS, MD, Professor, Department of Internal Medicine, Armed Forces Medical College, Solapur Road, Pune 411040, Maharashtra, India. manishmanrai@yahoo.com

Received: January 28, 2021
Peer-review started: January 28, 2021
First decision: May 2, 2021
Revised: May 9, 2021
Accepted: August 16, 2021
Article in press: August 16, 2021
Published online: October 21, 2021
Processing time: 264 Days and 13.9 Hours

Abstract

Pancreatic carcinoma (PC) is one of the leading causes of cancer-related deaths worldwide. Despite early detection and advances in therapeutics, the prognosis remains dismal. The outcome and therapeutic approach are dependent on the stage of PC at the time of diagnosis. The standard of care is surgery, followed by adjuvant chemotherapy. The advent of newer drugs has changed the landscape of adjuvant therapy. Moreover, recent trials have highlighted the role of neoadjuvant therapy and chemoradiotherapy for resectable and borderline resectable PC. As we progress towards a better understanding of tumor biology, genetics, and microenvironment, novel therapeutic strategies and targeted agents are now on the horizon. We have described the current and emerging therapeutic strategies in PC.

Keywords: Resectable pancreatic carcinoma; Borderline resectable pancreatic carcinoma; Locally advanced pancreatic carcinoma; Adjuvant therapy; Neoadjuvant therapy; Newer advances in pancreatic carcinoma

Core Tip: An improved understanding of the natural history of pancreatic carcinoma, genetics, and tumor biology has highlighted the role of novel therapeutic strategies. However, despite recent advances in the management of pancreatic carcinoma, the prognosis remains poor. We have attempted to conceptualize the current therapeutic strategies in light of recent advances.