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Cancers
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Pancreatic Cancer: Clinical Standards, Unmet Needs and Future Directions
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Pancreatic Cancer: Clinical Standards, Unmet Needs and Future Directions

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

Deadline for manuscript submissions: 31 December 2025 | Viewed by 1311

Special Issue Editor

Prof. Dr. Dimitrios H. Roukos

E-Mail Website
Guest Editor
Centre for Biosystems and Genome Network Medicine, Ioannina University, Ioannina, Greece
Interests: precision cancer medicine; precision immuno-oncoloy; precision oncology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Pancreatic cancer is a highly complex and heterogeneous disease, with the worst prognosis among leading cancer types. Late diagnosis, minimal residual disease (MRD) following surgical resections and resistance to current standard neoadjuvant and/or adjuvant chemotherapy are the causes of alarmingly high recurrence rates (80–90%).

To overcome these unmet challenges, breakthrough patient-centric research focuses on the development of prognostic and predictive biomarkers to eliminate MRD through meaningful therapy. Towards this direction, this Special Issue invites a wide spectrum of clinicians such as surgical and medical oncologists, as well as researchers aiming to develop comprehensive rational treatment with targeted therapy and immunotherapy. Considering the limitations of chemotherapy and targeted therapy, research interest concentrates on how to enhance the natural capacity of immune cells within the tumor microenvironment (TME). Harnessing multiomics technologies at bulk and particularly single-cell resolution, the goal of cancer immunotherapy, encompassing immune checkpoint inhibitors (ICIs), adoptive cellular therapy and mRNA vaccines, could be achieved over the next decade. Indeed, phase II/III trials are ongoing, evaluating the clinical utility of next-generation bispecific antibodies for dual checkpoint inhibition. Moreover, on the basis of the successful mRNA cancer vaccines in phase I clinical trials, a global randomized trial will take place soon. The development of tumor and liquid biopsy biomarkers can further improve the efficacy of these immunotherapies by enabling precision immunotherapy.

Prof. Dr. Dimitrios H. Roukos
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 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

  • standard clinical management
  • surgery
  • neoadjuvant and/or adjuvant treatment
  • cancer immunotherapy
  • targeted therapy
  • detection and elimination of MRD

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Published Papers (2 papers)

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Research

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11 pages, 2063 KiB  
Article
Postoperative Geriatric Nutritional Risk Index as a Determinant of Tolerance to S-1 Adjuvant Chemotherapy After Curative Surgery for Pancreatic Ductal Adenocarcinoma: A Cohort Study with External Validation
by Naotake Funamizu, Akimasa Sakamoto, Shozo Mori, Miku Iwata, Mikiya Shine, Chihiro Ito, Mio Uraoka, Yoshitomo Ueno, Kei Tamura, Yoshiaki Kamei, Yasutsugu Takada, Taku Aoki and Yuzo Umeda
Cancers 2025, 17(9), 1448; https://doi.org/10.3390/cancers17091448 - 26 Apr 2025
Viewed by 464
Abstract
S-1 adjuvant chemotherapy (AC) is the standard treatment for pancreatic ductal adenocarcinoma (PDAC) after curative surgery in Japan. Our prior research suggested that a lower postoperative geriatric nutritional risk index (GNRI) predicts S-1 discontinuation due to adverse events (AEs). This study aimed to [...] Read more.
S-1 adjuvant chemotherapy (AC) is the standard treatment for pancreatic ductal adenocarcinoma (PDAC) after curative surgery in Japan. Our prior research suggested that a lower postoperative geriatric nutritional risk index (GNRI) predicts S-1 discontinuation due to adverse events (AEs). This study aimed to validate the GNRI as a predictor of S-1 non-completion using an independent cohort. Methods: This retrospective study analyzed 180 patients who underwent curative PDAC resection at Dokkyo Medical University from January 2010 to March 2023. Postoperative GNRI values were recorded as part of nutritional screening. Data on S-1 therapy completion and related clinical factors were analyzed statistically. Results: Patients were classified based on S-1 completion (N = 93) and non-completion (N = 48). GNRI values were significantly lower in the non-completion group. A GNRI threshold of 94.4, identified in a prior study, effectively distinguished patients at risk of discontinuation. Univariate analysis confirmed that a GNRI of ≥94.4 was a significant predictor of successful S-1 completion [hazard ratio (HR) for recurrence-free survival (RFS), 1.54; 95% confidence interval (CI) 1.04–2.28 and for overall survival (OS), 1.89; 95% CI 1.20–2.99]. Conclusions: This study validated previous findings, confirming that the postoperative GNRI reliably identifies patients at risk of S-1 non-completion due to AEs after PDAC surgery. The GNRI serves as a practical marker for optimizing patient care and enhancing AC efficacy. Full article
(This article belongs to the Special Issue Pancreatic Cancer: Clinical Standards, Unmet Needs and Future Directions)
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Review

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47 pages, 1236 KiB  
Review
Cancer Vaccination and Immune-Based Approaches in Pancreatic Cancer
by Matthew Bloom, Ali Raza Shaikh, Zhengyang Sun, Babar Bashir and Adam E. Snook
Cancers 2025, 17(14), 2356; https://doi.org/10.3390/cancers17142356 - 15 Jul 2025
Viewed by 384
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy with high recurrence rates even after curative resection and adjuvant chemotherapy. Although immunotherapeutic approaches, such as immune checkpoint blockade (ICB), have revolutionized the treatment of some solid tumor malignancies, this has not been the case [...] Read more.
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy with high recurrence rates even after curative resection and adjuvant chemotherapy. Although immunotherapeutic approaches, such as immune checkpoint blockade (ICB), have revolutionized the treatment of some solid tumor malignancies, this has not been the case for PDAC. Several characteristics of PDAC, including its distinctive desmoplastic tumor microenvironment (TME), intratumor heterogeneity, and poor antigenicity and immune cell infiltration, contribute to its dismal immunotherapeutic landscape. Cancer vaccines offer one approach to overcoming these barriers, particularly in the resectable or borderline resectable settings, where tumor burden is low and immunosuppression is less pronounced. Various vaccination platforms have been tested in the clinical setting, from off-the-shelf peptide-based vaccines (e.g., AMPLFIFY-201 study, where over 80% of participants exhibited T-cell and biomarker responses) to personalized neoantigen mRNA vaccine approaches (e.g., autogene cevumeran, with significant responders experiencing longer median recurrence-free survival (RFS)). The key considerations for enhancing the efficacy of vaccination include combinations with chemotherapy, radiotherapy, and/or ICBs, as well as selecting appropriate immunomodulators or adjuvants. Recent results suggest that with continued mechanistic advancement and novel therapeutic development, cancer vaccines may finally be poised for clinical success in PDAC. Full article
(This article belongs to the Special Issue Pancreatic Cancer: Clinical Standards, Unmet Needs and Future Directions)
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