Published online Dec 28, 2022. doi: 10.3748/wjg.v28.i48.6827
Peer-review started: September 17, 2022
First decision: October 30, 2022
Revised: November 4, 2022
Accepted: November 28, 2022
Article in press: November 28, 2022
Published online: December 28, 2022
Processing time: 100 Days and 16.3 Hours
Pancreatic cancer (PC) is the third-leading cause of cancer deaths. The overall 5-year survival rate of PC is 9%, and this rate for metastatic PC is below 3%. However, the PC-induced death cases will increase about 2-fold by 2060. Many factors such as genetic and environmental factors and metabolic diseases can drive PC development and progression. The most common type of PC in the clinic is pancreatic ductal adenocarcinoma, comprising approximately 90% of PC cases. Multiple pathogenic processes including but not limited to inflammation, fibrosis, angiogenesis, epithelial-mesenchymal transition, and proliferation of cancer stem cells are involved in the initiation and progression of PC. Early diagnosis is essential for curable therapy, for which a combined panel of serum markers is very helpful. Although some mono or combined therapies have been approved by the United States Food and Drug Administration for PC treatment, current therapies have not shown promising outcomes. Fortunately, the development of novel immunotherapies, such as oncolytic viruses-mediated treatments and chimeric antigen receptor-T cells, combined with therapies such as neoadjuvant therapy plus surgery, and advanced delivery systems of immunotherapy will improve therapeutic outcomes and combat drug resistance in PC patients. Herein, the pathogenesis, molecular signaling pathways, diagnostic markers, prognosis, and potential treatments in completed, ongoing, and recruiting clinical trials for PC were reviewed.
Core Tip: Pancreatic cancer (PC) is the third-leading cause of cancer deaths. Pancreatic ductal adenocarcinoma is the most common type of PC in the clinic. Multiple pathogenic processes including inflammation, fibrosis, angiogenesis, epithelial-mesenchymal transition, and proliferation of cancer stem cells are involved in PC initiation and progression. Although some therapies have been approved for PC treatment, the overall 5-year survival rate is still very low. A combined panel of serum markers is very helpful for PC diagnosis. New treatments and more clinical trials are required to search for new potent therapeutic agents and to evaluate their efficacy in PC treatment.