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Current Strategies in Pancreatic Cancer Management: Intense Systemic Treatment and...
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Current Strategies in Pancreatic Cancer Management: Intense Systemic Treatment and Aggressive Local Tumor Control. When Shall We Do What?

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 8158

Special Issue Editor

Prof. Dr. Ingmar Königsrainer

E-Mail Website
Guest Editor
Department of General, Visceral and Thoracic Surgery, Landeskrankenhaus Feldkirch, Feldkirch, Austria
Interests: hepatobiliary surgery; pancreatic surgery; peritoneal carcinomatosis; transplantation

Special Issue Information

Dear Colleagues, 

Treatment of patients with pancreatic cancer is still a major problem especially due to aggressive tumor biology itself and the potential high morbidity of surgical treatment.

The aim of the Special Issue is to focus on novel systemic and local therapeutic approaches, finding the ideal therapy sequence for each individual patient. Revolutionary steps in medical oncology such as immunotherapy and liquid biopsy may further contribute to improving treatment.

Radical surgical exploration with vessel orientated resections makes pancreatic surgery safer and more radical.

In this Special Issue, original research articles and reviews are welcome.

We look forward to receiving your contributions.

Prof. Dr. Ingmar Königsrainer
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pancreatic surgery
  • radiotherapy
  • chemotherapy
  • radiotherapy
  • immunotherapy

Published Papers (3 papers)

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Research

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10 pages, 2164 KiB  
Article
MRI-Based Tumor Necrosis Depiction in Pancreatic Ductal Adenocarcinoma: Can It Predict Tumor Aggressiveness?
by Mark A. Anderson, David E. Knipp, Yoshifumi Noda, Sophia C. Kamran, Vinit Baliyan, Hamed Kordbacheh, Theodore S. Hong and Avinash Kambadakone
Cancers 2023, 15(8), 2313; https://doi.org/10.3390/cancers15082313 - 15 Apr 2023
Cited by 1 | Viewed by 1990
Abstract
The purpose of this study was to investigate whether tumor necrosis depicted on contrast-enhanced abdominal MRI can predict tumor aggressiveness in pancreatic ductal adenocarcinoma (PDAC). In this retrospective analysis, we included 71 patients with pathology-proven PDAC who underwent contrast-enhanced MRI from 2006 to [...] Read more.
The purpose of this study was to investigate whether tumor necrosis depicted on contrast-enhanced abdominal MRI can predict tumor aggressiveness in pancreatic ductal adenocarcinoma (PDAC). In this retrospective analysis, we included 71 patients with pathology-proven PDAC who underwent contrast-enhanced MRI from 2006 to 2020. Assessment for the presence/absence of imaging detected necrosis was performed on T2-weighted and contrast-enhanced T1-weighted images. Primary tumor characteristics, regional lymphadenopathy, metastases, stage, and overall survival were analyzed. Fisher’s exact and Mann-Whitney U tests were used for statistical analysis. Of the 72 primary tumors, necrosis was identified on MRI in 58.3% (42/72). Necrotic PDACs were larger (44.6 vs. 34.5 mm, p = 0.0016), had higher rates of regional lymphadenopathy (69.0% vs. 26.7%, p = 0.0007), and more frequent metastases (78.6% vs. 40.0%, p = 0.0010) than those without MRI-evident necrosis. A non-statistically significant reduction in median overall survival was observed in patients with versus without MRI-evident necrosis (15.8 vs. 38.0 months, p = 0.23). PDAC tumor necrosis depicted on MRI was associated with larger tumors and higher frequency of regional lymphadenopathy and metastases. Full article
(This article belongs to the Special Issue Current Strategies in Pancreatic Cancer Management: Intense Systemic Treatment and Aggressive Local Tumor Control. When Shall We Do What?)
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15 pages, 2662 KiB  
Article
Stereotactic MR-Guided Adaptive Radiotherapy for Pancreatic Tumors: Updated Results of the Montpellier Prospective Registry Study
by Karl Bordeau, Morgan Michalet, Aïcha Keskes, Simon Valdenaire, Pierre Debuire, Marie Cantaloube, Morgane Cabaillé, Fabienne Portales, Roxana Draghici, Marc Ychou, Eric Assenat, Thibault Mazard, Emmanuelle Samalin, Ludovic Gauthier, Pierre-Emmanuel Colombo, Sebastien Carrere, François-Régis Souche, Norbert Aillères, Pascal Fenoglietto, David Azria and Olivier Riouadd Show full author list remove Hide full author list
Cancers 2023, 15(1), 7; https://doi.org/10.3390/cancers15010007 - 20 Dec 2022
Cited by 11 | Viewed by 2110
Abstract
Introduction: Stereotactic MR-guided Adaptive RadioTherapy (SMART) is a novel process to treat pancreatic tumors. We present an update of the data from our prospective registry of SMART for pancreatic tumors. Materials and methods: After the establishment of the SMART indication in a multidisciplinary [...] Read more.
Introduction: Stereotactic MR-guided Adaptive RadioTherapy (SMART) is a novel process to treat pancreatic tumors. We present an update of the data from our prospective registry of SMART for pancreatic tumors. Materials and methods: After the establishment of the SMART indication in a multidisciplinary board, we included all patients treated for pancreatic tumors. Primary endpoints were acute and late toxicities. Secondary endpoints were survival outcomes (local control, overall survival, distant metastasis free survival) and dosimetric advantages of adaptive process on targets volumes and OAR. Results: We included seventy consecutive patients in our cohort between October 2019 and April 2022. The prescribed dose was 50 Gy in 5 consecutive fractions. No severe acute SMART related toxicity was noted. Acute and late Grade ≤ 2 gastro intestinal were low. Daily adaptation significantly improved PTV and GTV coverage as well as OAR sparing. With a median follow-up of 10.8 months since SMART completion, the median OS, 6-months OS, and 1-year OS were 20.9 months, 86.7% (95% CI: (75–93%), and 68.6% (95% CI: (53–80%), respectively, from SMART completion. Local control at 6 months, 1 year, and 2 years were, respectively, 96.8 % (95% CI: 88–99%), 86.5 (95% CI: 68–95%), and 80.7% (95% CI: 59–92%). There was no grade > 2 late toxicities. Locally Advanced Pancreatic Cancers (LAPC) and Borderline Resectable Pancreatic Cancers (BRPC) patients (52 patients) had a median OS, 6-months OS, and 1-year OS from SMART completion of 15.2 months, 84.4% (95% CI: (70–92%)), and 60.5% (95% CI: (42–75%)), respectively. The median OS, 1-year OS, and 2-year OS from initiation of induction chemotherapy were 22.3 months, 91% (95% CI: (78–97%)), and 45.8% (95% CI: (27–63%)), respectively. Twenty patients underwent surgical resection (38.7 % of patients with initially LAPC) with negative margins (R0). Conclusion: To our knowledge, this is the largest series of SMART for pancreatic tumors. The treatment was well tolerated with only low-grade toxicities. Long-term OS and LC rates were achieved. SMART achieved high secondary resection rates in LAPC patients. Full article
(This article belongs to the Special Issue Current Strategies in Pancreatic Cancer Management: Intense Systemic Treatment and Aggressive Local Tumor Control. When Shall We Do What?)
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Review

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36 pages, 2056 KiB  
Review
Pancreatic Cancer: Challenges and Opportunities in Locoregional Therapies
by Alaa Y. Bazeed, Candace M. Day and Sanjay Garg
Cancers 2022, 14(17), 4257; https://doi.org/10.3390/cancers14174257 - 31 Aug 2022
Cited by 16 | Viewed by 3536
Abstract
Pancreatic cancer (PC) remains the seventh leading cause of cancer-related deaths worldwide and the third in the United States, making it one of the most lethal solid malignancies. Unfortunately, the symptoms of this disease are not very apparent despite an increasing incidence rate. [...] Read more.
Pancreatic cancer (PC) remains the seventh leading cause of cancer-related deaths worldwide and the third in the United States, making it one of the most lethal solid malignancies. Unfortunately, the symptoms of this disease are not very apparent despite an increasing incidence rate. Therefore, at the time of diagnosis, 45% of patients have already developed metastatic tumours. Due to the aggressive nature of the pancreatic tumours, local interventions are required in addition to first-line treatments. Locoregional interventions affect a specific area of the pancreas to minimize local tumour recurrence and reduce the side effects on surrounding healthy tissues. However, compared to the number of new studies on systemic therapy, very little research has been conducted on localised interventions for PC. To address this unbalanced focus and to shed light on the tremendous potentials of locoregional therapies, this work will provide a detailed discussion of various localised treatment strategies. Most importantly, to the best of our knowledge, the aspect of localised drug delivery systems used in PC was unprecedentedly discussed in this work. This review is meant for researchers and clinicians considering utilizing local therapy for the effective treatment of PC, providing a thorough guide on recent advancements in research and clinical trials toward locoregional interventions, together with the authors’ insight into their potential improvements. Full article
(This article belongs to the Special Issue Current Strategies in Pancreatic Cancer Management: Intense Systemic Treatment and Aggressive Local Tumor Control. When Shall We Do What?)
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