Pancreatic cancer

Area of Science:

• Oncology
• Gastroenterology

Background:

• Pancreatic cancer has a high mortality rate, with most patients asymptomatic until advanced stages.
• No standard screening exists for high-risk individuals, including those with a family history or chronic pancreatitis.
• Pancreatic tumors often originate from microscopic precursor lesions called pancreatic intraepithelial neoplasias.

Purpose of the Study:

• To review the current understanding of pancreatic cancer, including its pathogenesis, diagnosis, and treatment.
• To highlight key genetic drivers and diagnostic modalities.
• To outline therapeutic strategies for both resectable and unresectable pancreatic cancer.

Main Methods:

• Literature review of pancreatic cancer pathogenesis, genetics, and clinical management.
• Analysis of diagnostic techniques such as endoscopic ultrasonography and fine-needle aspiration.
• Summary of current treatment guidelines, including surgical resection, adjuvant chemotherapy, and systemic therapies.

Main Results:

• KRAS, CDKN2A, TP53, and SMAD4 are major driver genes, with KRAS mutations and CDKN2A alterations being early events.
• Endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (FNA) demonstrate high diagnostic accuracy.
• Surgical resection offers the only potential cure, with adjuvant chemotherapy (gemcitabine or S-1) recommended post-surgery.

Conclusions:

• Pancreatic cancer requires early detection due to late-stage asymptomatic presentation.
• Multimodal treatment approaches, including surgery and chemotherapy (FOLFIRINOX or gemcitabine/nab-paclitaxel), are essential.
• Further research into screening and early intervention is critical for improving patient survival rates.