Copyright
©The Author(s) 2021.
World J Gastroenterol. Sep 21, 2021; 27(35): 5851-5889
Published online Sep 21, 2021. doi: 10.3748/wjg.v27.i35.5851
Published online Sep 21, 2021. doi: 10.3748/wjg.v27.i35.5851
Table 1 Genetic syndromes predisposing to pancreatic cancer (the frequency of mutated genes among patients with pancreatic ductal adenocarcinoma is indicated in brackets)
Genetic syndrome | Mutated genes |
Hereditary breast/ovarian cancer syndrome[36,37] | BRCA1 (0.7%), BRCA2 (1.4%), PALB2 (1%) |
Familial atypical multiple mole melanoma syndrome[38] | CDKN2A (0.7%) |
Peutz-Jeghers syndrome[39] | STK11 |
Familial adenomatous polyposis | APC (0.4%) |
Lynch syndrome[40] | MLH1, MSH2 (0.4%), PMS2 (0.3%) |
Hereditary pancreatitis[41] | PRSS1, SPINK1 |
Ataxia telangectasia[42] | ATM (1.4%) |
Li-Fraumeni syndrome[42] | P53 (0.4%) |
Table 2 Resectability criteria
Resectability status | Resectable | Borderline resectable | Locally advanced | |
Arterial involvement | Celiac artery | None | ≤ 180°; > 180°, without involvement of aorta o GDA (body/tail) | >180° (head/uncinate); Solid tumor contact with CA and aorta |
SMA common hepatic artery | None | ≤ 180°; Solit tumor contact without extension into CA or hepatic artery biforcation | > 180° | |
Venous involvement (portal vein/smv) | None; ≤ 180° contact without contour irregularity | > 180°; ≤ 180° with contour irregularity or thrombosis, with reconstructible PV/SMV; Solid tumor contact with IVC | Unreconstractible PV/SMV due to tumor involvement or occlusion |
Table 3 Resectability criteria and societies
Vessel involvement | NCCN 2019 | MDACC | ACTO | AHPBA/SSAT/SSO |
CA abutment (≤ 180°) | Borderline | Borderline | Borderline | Unresectable |
CA encasement (> 180°) | Borderline (body/tail); locally advanced (head/uncinate) | Unresectable | Unresectable | Unresectable |
SMA abutment (< 180°); SMA encasement (> 180°); CHA abutment or encasement | Borderline; Locally advanced; Borderline | Borderline; Unresectable; Borderline | Borderline; Unresectable; Borderline | Borderline; Unresectable; Borderline |
PV/SMV encasement (> 180°) or abutment (≤ 180°) with contour abnormality | Borderline | Borderline | Borderline | Borderline |
Table 4 Phase of trial and level of evidence of trial about chemotherapy for resectable and borderline resectable pancreatic ductal adenocarcinoma
Ref. | Phase of trial | Level of evidence |
Neoptolemos et al[185] | III | II |
Oettle et al[186] | III | I |
Neoptolemos et al[187] | III | I |
Neoptolemos et al[188] | III | I |
Conroy et al[189] | III | I |
You et al[195] | III | II |
van Roessel et al[198] | IV | II |
Versteijne et al[202] | III | II |
Ghaneh et al[205] | II | II |
Sohal et al[207] | IV | II |
Labori et al[209] | III | II |
Schwarz et al[210] | II | I |
Ettrich et al[211] | II | II |
Motoi et al[212] | III | II |
UMIN-CTR Clinical Trial[215] (UMIN000026858) | III | II |
Table 5 Phase and level of evidence of trials about immunotherapy for pancreatic ductal adenocarcinoma
Ref. | Phase of trial | Level of evidence |
Royal et al[245] | II | II |
Brahmer et al[246] | I | I |
O'Reilly et al[247] | II | II |
Tumeh et al[248] | II | III |
Le et al[250] | II | II |
Le et al[251] | II | II |
Wainberg et al[252] | I | II |
Weiss et al[253] | Ib/II | II |
National Institute of Public Health[254] (JapicCTI-184230,ONO-4538) | II | II |
Wang-Gillam et al[255] | II | II |
Le et al[257] | IIb | I |
Asahara et al[258] | I/II | II |
Suzuki et al[259] | II | III |
Miyazawa et al[260] | II | II |
Wedén et al[261] | IV | III |
Toubaji et al[262] | I | III |
Abou-Alfa et al[263] | I/II | III |
Cohn et al[264] | I | III |
Katsuda et al[265] | III | I |
Katsuda et al[266] | I/II | II |
Beatty et al[270] | I | III |
Le et al[271] | Ib | II |
Chung et al[272] | I | III |
Wang-Gillam et al[273] | I | III |
Reiss et al[274] | II | III |
Desai et al[275] | Ib/II | Ongoing trial |
Chang et al[278] | I | III |
Noonan et al[279] | II | II |
Mahalingam et al[280] | Ib | III |
- Citation: Tonini V, Zanni M. Pancreatic cancer in 2021: What you need to know to win. World J Gastroenterol 2021; 27(35): 5851-5889
- URL: https://www.wjgnet.com/1007-9327/full/v27/i35/5851.htm
- DOI: https://dx.doi.org/10.3748/wjg.v27.i35.5851