Review of Current Systemic Therapy and Novel Systemic Therapy for Pancreatic Ductal Adenocarcinoma
Round 1
Reviewer 1 Report
Thank you for inviting me to review an excellent review paper regarding systemic therapy for pancreatic cancer. This manuscript is well written and systematically summarize the recent data regarding PDAC treatment.
Thus, I suggest a minor revisions to improve present form of this manuscript.
Minor revision
1) You'd better comment an Immunotherapy targeting T-cell, which is being applied to various solid cancers. Additional information on CART T cell therapy is needed. (ref. Neoantigen T-Cell Receptor Gene Therapy in Pancreatic Cancer, NEJM 2002)
2) Rather than displaying the reference column in all tables, it is better to create row column and indicate the author and/or study name (title) into that.
Thank you
Author Response
Thank you for inviting me to review an excellent review paper regarding systemic therapy for pancreatic cancer. This manuscript is well written and systematically summarize the recent data regarding PDAC treatment.
Thus, I suggest a minor revisions to improve present form of this manuscript.
Minor revision
1) You'd better comment an Immunotherapy targeting T-cell, which is being applied to various solid cancers. Additional information on CART T cell therapy is needed. (ref. Neoantigen T-Cell Receptor Gene Therapy in Pancreatic Cancer, NEJM 2002)
We appreciate your comment. It was added in the discussion section.
“Although the outcomes have significantly evolved in the last couple of decades with combination chemotherapeutic regimens, current standard systemic treatment shows modest anticancer activity, and prognosis still remains poor. To improve clinical outcome of pancreatic cancer, better understanding of molecular biology of pancreatic cancer and limitation of the current available systemic treatment approaches is essential. Multidisciplinary approaches, comprehensive germline and somatic gene testing and complementary/supportive care should be considered to improve clinical outcome and quality of life in patients with pancreatic cancer.”
2) Rather than displaying the reference column in all tables, it is better to create row column and indicate the author and/or study name (title) into that.
The recommendation is appreciated. However, in order to keep the table concise and less verbose, the reference column is still being utilized with referenced studies listed at the end.
Reviewer 2 Report
A lot of content was well organized with a review paper written in a well-organized framework in detail. It is worth publishing in this journal and is thought to be seen and quoted by many scientists. However, I think it would be a better paper if the following contents were added.
1.These days, complementary and alternative medicine is developing, and related treatments are being conducted in many places. In addition, there are a lot of related papers. I know that many of these treatments are being conducted in pancreatic cancer, so I suggest there is a simple mention of this.
2.Results part in abstract is too short. Please supplement the contents.
3.There is no purpose of writing this article in Introduction, and there is a lack of content to write about. Please supplement the relevant content.
4.Please supplement how many related papers from 1996 to 2023 are involved in the Materials and Methods. In addition, when dividing each category, please organize and supplement what the key word was and how many papers each category had.
5.There is a Discussion part, but there is nothing Discussion. Please supplement the vision of pancreatic cancer treatment in the future.
Author Response
1.These days, complementary and alternative medicine is developing, and related treatments are being conducted in many places. In addition, there are a lot of related papers. I know that many of these treatments are being conducted in pancreatic cancer, so I suggest there is a simple mention of this.
We appreciate your comment. It was added in the results section for our article.
“ Complementary therapy such as acupuncture, biofeedback, dietary supplements, massage therapy and meditation has been conducted in combination with standard systemic treatment to minimize therapy-related toxicities and improve quality of life in cancer patients. Since patients with pancreatic cancer are usually associated with a high symptom burden including cancer pain, cachexia and pancreatic exocrine insufficiency in addition to cancer therapy-related toxicities, effective supportive care with complementary therapy may improve not only adherence to cancer therapy but also quality of life. Although further prospective studies are needed to investigate the benefit of complementary therapy, early studies suggest complementary therapy including acupuncture, massage therapy, physical activity and nutrition support can reduce symptom burden in pancreatic cancer”
2.Results part in abstract is too short. Please supplement the contents.
We appreciate your suggestion. It was added in the abstract.
“The introduction of polychemotherapy regimens including gemcitabine/nab-paclitaxel and FOLFIRINOX (oxaliplatin, irinotecan, folinic acid and fluorouracil) has improved clinical outcome of advanced pancreatic cancer. For further improvement of clinical outcome, several novel approaches have been extensively studied in pancreatic cancer”
3.There is no purpose of writing this article in Introduction, and there is a lack of content to write about. Please supplement the relevant content.
Thank you for this suggestion. It was added in the introduction.
“The introduction of multiagent chemotherapy regimens have remarkably improved the clinical outcome of advanced pancreatic cancer. However, 5-year survival rates for metastatic pancreatic cancer are less than 5%. To improve clinical outcome of pancreatic cancer, better understanding of benefit and limitation of systemic treatment options is needed. This review summarizes current standard systemic approaches and novel systemic approaches to improve our understanding of pancreatic cancer management.”
4.Please supplement how many related papers from 1996 to 2023 are involved in the Materials and Methods. In addition, when dividing each category, please organize and supplement what the key word was and how many papers each category had.
Thank you for the recommendation. The related articles reviewed along with their categorization were added to the materials and methods section for the article.
5.There is a Discussion part, but there is nothing Discussion. Please supplement the vision of pancreatic cancer treatment in the future.
We appreciate your comment. It was added in the discussion.
“Although the outcomes have significantly evolved in the last couple of decades with combination chemotherapeutic regimens, current standard systemic treatment shows modest anticancer activity, and prognosis still remains poor. To improve clinical outcome of pancreatic cancer, better understanding of molecular biology of pancreatic cancer and limitation of the current available systemic treatment approaches is essential. Multidisciplinary approaches, comprehensive germline and somatic gene testing and complementary/supportive care should be considered to improve clinical outcome and quality of life in patients with pancreatic cancer.”
Round 2
Reviewer 2 Report
It is well revised.
