Stromal biology and therapy in pancreatic cancer: a changing paradigm

Pancreatic ductal adenocarcinoma (PDA) exhibits one of the poorest prognosis of all solid tumours and poses an unsolved problem in cancer medicine. Despite the recent success of two combination chemotherapies for palliative patients, the modest survival benefits are often traded against significant side effects and a compromised quality of life. Although the molecular events underlying the initiation and progression of PDA have been intensively studied and are increasingly understood, the reasons for the poor therapeutic response are hardly apprehended. One leading hypothesis over the last few years has been that the pronounced tumour microenvironment in PDA not only promotes carcinogenesis and tumour progression but also mediates therapeutic resistance. To this end, targeting of various stromal components and pathways was considered a promising strategy to biochemically and biophysically enhance therapeutic response. However, none of the efforts have yet led to efficacious and approved therapies in patients. Additionally, recent data have shown that tumour-associated fibroblasts may restrain rather than promote tumour growth, reinforcing the need to critically revisit the complexity and complicity of the tumour–stroma with translational implications for future therapy and clinical trial design.
Source: Gut - Category: Gastroenterology Authors: Tags: GUT Recent advances in basic science, Pancreas and biliary tract, Pancreatic cancer Source Type: research

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The clinical application of photodynamic therapy (PDT) for gastrointestinal (GI) neoplastic lesions has been developed with appreciation for the great efforts and kind support of Dr. Tom Dougherty and his followers ’ contributions.There are several published studies on clinical PDT in the field of GI oncology including esophageal cancer, Barret’s esophagus, gastric cancer, biliary cancer and pancreatic cancer. In this review, we overview the history, present status and future perspective of PDT for GI canc er in clinical. AbstractThe clinical application of photodynamic therapy (PDT) for gastrointestinal (GI) n...
Source: Photochemistry and Photobiology - Category: Science Authors: Tags: Special Issue Invited Review Source Type: research
Pancreatic ductal adenocarcinoma (PDAC) has still a dismal prognosis, mainly because only 15–20% of all patients present with resectable tumor stages at the time of diagnosis. Due to locally extended tumor growth or distant metastases upfront resection is not reasonable in the majority of patients. Considerably, PDAC will be the 2nd most frequent cause of cancer-related deaths within the next 10 years for both men and women. While there is currently no convincing evidence for the use of neoadjuvant therapy in resectable PDAC, there are controversial results from studies investigating neoadjuvant treatment concepts in...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
AbstractThe clinical application of photodynamic therapy (PDT) for gastrointestinal (GI) neoplastic lesions has been developed with appreciation for the great efforts and kind support of Dr. Tom Dougherty and his followers ’ contributions. There are several published studies on clinical PDT in the field of GI oncology. Esophageal cancer was one of the first clinical indications for PDT that was approved as an endoscopic procedure in both the United States and Japan. PDT was initially used as a palliative local treat ment for patients with obstructive esophageal cancer. PDT is also indicated for eradicative therapy fo...
Source: Photochemistry and Photobiology - Category: Science Authors: Tags: SPECIAL ISSUE RESEARCH ARTICLE Source Type: research
AbstractThe primary tumor site of pancreatic cancer has been suggested as a recommended variable in future studies of treatments of patients with unresectable or metastatic pancreatic adenocarcinoma (mPDAC). The aim of the current study is to analyze the differences between mPDAC of the head and mPDAC of the body-tail, both in prognostic and predictive terms in patients with mPDAC receiving palliative chemotherapy. Data of patients with a diagnosis of mPDAC and receiving chemotherapy (CHT), registered in the database of the division of Medical Oncology of the Ospedale Civile di Sanremo, were analyzed. Thirty-two variables ...
Source: Clinical and Experimental Metastasis - Category: Cancer & Oncology Source Type: research
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Source: Seminars in Interventional Radiology - Category: Radiology Authors: Tags: Review Article Source Type: research
Pancreatic ductal adenocarcinoma is the third leading cause of cancer death in the United States, accounting for approximately 45  750 deaths per year, and is projected to become the second leading cause of cancer death by 2020. The vast majority of patients with pancreatic cancer are diagnosed at a late stage of disease, when treatments are palliative. Only 10% of patients diagnosed with pancreatic cancer undergo potentiall y curative surgery, and 5-year survival across all stages is approximately 9%. Early diagnosis and detection of precursor lesions is therefore an attractive approach to decrease pancreatic cancer mor...
Source: JAMA - Category: General Medicine Source Type: research
Previous studies comparing primary tumor resection (PTR) to palliative treatment for advanced-stage pancreatic ductal adenocarcinoma (PDA) were limited by strong selection bias. We used multiple methods to con...
Source: BMC Cancer - Category: Cancer & Oncology Authors: Tags: Research article Source Type: research
Fausto Petrelli Despite extensive research, pancreatic ductal adenocarcinoma (PDAC) remains a difficult-to-treat cancer associated with poor survival. Due to the known aggressive disease biology, palliative chemotherapy is the only routinely recommended treatment in the metastatic setting in patients with adequate performance status. However, in a subset of patients with oligometastatic disease, multimodality treatment with surgery and/or locoregional approaches may provide long-term disease control and prolong survival. In fact, in highly selected cases, median overall survival has been reported to extend to 56 months...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Review Source Type: research
CONCLUSION: IBT is an overall safe procedure, which facilitates high rates of local tumor control in treatment of metastatic gastric adenocarcinoma. Compared to surgical metastasectomy, similar overall survival rates could be achieved in our patient collective after IBT application. PMID: 31348004 [PubMed - as supplied by publisher]
Source: Diagnostic and Interventional Radiology : The Turkish Society of Radiology - Category: Radiology Authors: Tags: Diagn Interv Radiol Source Type: research
SummaryPancreatic ductal adenocarcinoma is a highly aggressive malignancy with short survival and limited therapeutic options. Broccoli sulforaphane is a promising new treatment due to the results of recent epidemiological, experimental and patient studies. Upon approval from the ethics committee and registration atClinicalTrials.gov, 40 patients with palliative chemotherapy were placed into a placebo and treatment group in an unblinded fashion. Fifteen capsules with pulverized broccoli sprouts containing 90  mg/508 μmol sulforaphane and 180 mg/411 μmol glucoraphanin or methylcellulose were admini...
Source: Investigational New Drugs - Category: Drugs & Pharmacology Source Type: research
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