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Review
. 2024 Jul 1:14:1386699.
doi: 10.3389/fonc.2024.1386699. eCollection 2024.

Pancreatic ductal adenocarcinoma: the latest on diagnosis, molecular profiling, and systemic treatments

Doaa Bugazia  1 , Ebtesam Al-Najjar  2 , Abdullah Esmail  2 , Saifudeen Abdelrahim  3 , Karen Abboud  4 , Adham Abdelrahim  5 , Godsfavour Umoru  4 , Hashem A Rayyan  6 , Ala Abudayyeh  7 , Ala-Eddin Al Moustafa  8 , Maen Abdelrahim  2   9
Affiliations
Review

Pancreatic ductal adenocarcinoma: the latest on diagnosis, molecular profiling, and systemic treatments

Doaa Bugazia et al. Front Oncol. .

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is currently the fourth leading cause of death in the United States and is expected to be ranked second in the next 10 years due to poor prognosis and a rising incidence. Distant metastatic PDAC is associated with the worst prognosis among the different phases of PDAC. The diagnostic options for PDAC are convenient and available for staging, tumor response evaluation, and management of resectable or borderline resectable PDAC. However, imaging is crucial in PDAC diagnosis, monitoring, resectability appraisal, and response evaluation. The advancement of medical technologies is evolving, hence the use of imaging in PDAC treatment options has grown as well as the utilization of ctDNA as a tumor marker. Treatment options for metastatic PDAC are minimal with the primary goal of therapy limited to symptom relief or palliation, especially in patients with low functional capacity at the point of diagnosis. Molecular profiling has shown promising potential solutions that would push the treatment boundaries for patients with PDAC. In this review, we will discuss the latest updates from evidence-based guidelines regarding diagnosis, therapy response evaluation, prognosis, and surveillance, as well as illustrating novel therapies that have been recently investigated for PDAC, in addition to discussing the molecular profiling advances in PDAC.

Keywords: computed tomography (CT); magnetic resonance imaging (MRI); molecular profiling; pancreatic cancer novel therapy; pancreatic cancer treatments; pancreatic ductal adenocarcinoma; pancreatic neoplasm.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Treatment and staging strategy of pancreatic cancer. CT, Computed tomography; EUS, endoscopic ultrasound; MRI, magnetic resonance imaging; PET, positron emission tomography; SBRT, stereotactic body radiation therapy (9). NCCN guidelines recommend that biopsy for proof of malignancy is not required prior to surgical resection and should not delay surgical resection in patients with high clinical suspicion of pancreatic cancer.
Figure 2
Figure 2
The differences of origin, clinical presentation, and treatment in the PDAC Head and tail.
See this image and copyright information in PMC

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