Pancreatic Cancer

Like most solid tumor types, pancreatic cancer arises from the dysregulated proliferation of a given cell type. Pancreatic adenocarcinoma, which accounts for 95% of all pancreatic cancers,1 arises from cells lining pancreatic ducts2 and is characterized by an average of 63 genetic alterations per tumor and dysfunction of 12 key signaling pathways.3 In addition, pancreatic tumors are poorly vascularized and often surrounded by a dense desmoplastic stroma.4

The only potential cure for pancreatic cancer is surgical resection; however, < 20% of patients are candidates for surgery at the time of diagnosis.1,5 The majority of patients are diagnosed with metastatic disease.6 The remaining cases that are neither resectable nor metastatic are categorized as either locally advanced unresectable or borderline resectable based on involvement of the pancreatic tumor with nearby blood vessels and/or other tissues.5,7-9 Although recommendations from the National Comprehensive Cancer Network are consulted by many physicians for this classification,5,7,8 other institution-specific criteria may vary somewhat in the parameters used to distinguish between these 2 categories.9 Treatment recommendations depend on the stage of disease.5

The safety and efficacy of the agents and/or uses under investigation have not been established. There is no guarantee that the agents will receive health authority approval or become commercially available in any country for the uses being investigated

References

  1. American Cancer Society. Cancer Facts and Figures 2016. Atlanta, GA: www.cancer.org/research/cancerfactsstatistics/cancerfactsfigures2016/index.
  2. Hidalgo M. N Engl J Med. 2010;362:1605-1617.
  3. Jones S, et al. Science. 2008;321:1801-1806.
  4. Feig C, et al. Clin Cancer Res. 2012;18:4266-4276.
  5. NCCN Clinical Practice Guidelines in Oncology. Pancreatic Adenocarcinoma. V1.2017.
  6. National Cancer Institute. Surveillance, Epidemiology, and End Results Program. Cancer Stat Facts: Pancreatic Cancer. https://seer.cancer.gov/statfacts/html/pancreas.html. Accessed April 27, 2017.
  7. Al-Hawary M, et al. Radiology. 2014;270:248-260.
  8. Tempero MA, et al. J Natl Compr Canc Netw. 2014;12:1083-1093.
  9. MD Anderson Cancer Center. Pancreatic adenocarcinoma. https://www.mdanderson.org/documents/for-physicians/algorithms/cancer-treatment/ca-treatment-pancreatic-web-algorithm.pdf. Accessed April 27, 2017.