Therapeutic options for the management of pancreatic cancer
Therapeutic options for the management of pancreatic cancer
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DOI：
10.3748/wjg.v20.i32.11142
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发表时间：
2014-08-28
影响因子：
4.3
通讯作者：
Gondi, Christopher S.
中科院分区：
文献类型：
--
作者：
Rossi, Maria L.;Rehman, Azeem A.;Gondi, Christopher S.
由于其最初的特征，胰腺导管腺癌一直是最具破坏性和最难治疗的癌症之一。胰腺癌是美国第四大死因，估计每年导致38460人死亡。由于很少有筛查工具可在早期发现这种疾病，94%的患者将在诊断后五年内死亡。尽管经过几十年的研究，人们对胰腺癌细胞中的分子和细胞信号通路有了更好的了解，但针对这些通路的有效治疗方法却很少。其他治疗方案包括更复杂的胰腺癌手术和联合疗法。虽然这些患者的预后略有改善，但迫切需要更有效的治疗方法。除了胰腺癌细胞外，未来治疗这种恶性肿瘤的最大挑战之一将是开发针对肿瘤微环境和周围胰腺癌干细胞的疗法。针对胰腺星状细胞和基质的最新进展鼓励研究人员将重点转移到结缔组织增生在胰腺癌病理生物学中的作用，以期开发新一代的治疗方法。通过将新型药物与当前的细胞毒性化疗和放射治疗相结合，并根据特定的生物标志物对每位患者进行个性化治疗，可以实现延长患者生命的目标。在这里，我们回顾了用于治疗胰腺癌的最有效的治疗方法，并讨论了治疗方案的未来潜力。（三）2014年百世登出版集团股份有限公司版权所有。
Since its initial characterization, pancreatic ductal adenocarcinoma has remained one of the most devastating and difficult cancers to treat. Pancreatic cancer is the fourth leading cause of death in the United States, resulting in an estimated 38460 deaths annually. With few screening tools available to detect this disease at an early stage, 94% of patients will die within five years of diagnosis. Despite decades of research that have led to a better understanding of the molecular and cellular signaling pathways in pancreatic cancer cells, few effective therapies have been developed to target these pathways. Other treatment options have included more sophisticated pancreatic cancer surgeries and combination therapies. While outcomes have improved modestly for these patients, more effective treatments are desperately needed. One of the greatest challenges in the future of treating this malignancy will be to develop therapies that target the tumor microenvironment and surrounding pancreatic cancer stem cells in addition to pancreatic cancer cells. Recent advances in targeting pancreatic stellate cells and the stroma have encouraged researchers to shift their focus to the role of desmoplasia in pancreatic cancer pathobiology in the hopes of developing newer-generation therapies. By combining novel agents with current cytotoxic chemotherapies and radiation therapy and personalizing them to each patient based on specific biomarkers, the goal of prolonging a patient's life could be achieved. Here we review the most effective therapies that have been used for the treatment of pancreatic cancer and discuss the future potential of therapeutic options. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.