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Cancers
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Novel Diagnosis and Treatment Approaches in Pancreatic Cancer
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Novel Diagnosis and Treatment Approaches in Pancreatic Cancer

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

Deadline for manuscript submissions: 30 June 2026 | Viewed by 6007

Special Issue Editor

Prof. Dr. Atsushi Masamune

E-Mail Website
Guest Editor
Division of Gastroenterology, Graduate School of Medicine Sendai, Tohoku University, Sendai, Japan
Interests: molecular mechanisms of pancreatic diseases; pancreatic fibrosis; biomarkers; genetics of pancreatic diseases; epidemiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Pancreatic cancer still remains intractable due to difficulty in early diagnosis, its rapid progression, and its resistance to conventional therapy. To overcome these difficulties, multidisciplinary approaches including the development of novel diagnosis and treatment approaches are urgently needed. Recently, we have seen progress in the early diagnosis of pancreatic cancer such as the risk-factor stratification of new-onset diabetes mellitus, the development of microRNA-based biomarkers and cell-free DNA, and the identification of rather specific imaging findings. Regarding treatments, the efficacy of neoadjuvant chemotherapy has been proven, drugs that disrupt the tumor–stromal compartment might be useful for improved drug delivery, and targeted agents based on genetic testing such as PARP inhibitors for BRCA pathway-deficient pancreatic cancer and immune checkpoint inhibitors have shown promising results.

In this Special Issue, we will share up-to-date research findings in this field. Articles dealing with a wide range of novel diagnosis and treatment approaches in pancreatic cancer are welcome. Examples include, but are not limited to, the early diagnosis of pancreatic cancer based on risk factors, novel biomarkers, and imaging modalities including artificial intelligence. Basic, translational, and clinical research papers are all welcome.

Prof. Dr. Atsushi Masamune
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 250 words) can be sent to the Editorial Office for assessment.

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

  • pancreatic cancer
  • pancreatic fibrosis
  • biomarker
  • risk factor
  • genetic testing
  • artificial intelligence
  • endoscopic ultrasound
  • stroma
  • cancer-associated fibroblasts
  • familial pancreatic cancer

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Published Papers (3 papers)

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22 pages, 1524 KB  
Review
Strategies to Target the Tumor-Associated Macrophages in the Immunosuppressive Microenvironment of Pancreatic Ductal Adenocarcinoma
by Ryu Matsumoto, Kiyonori Tanoue, Chieri Nakayama, Masashi Okawa, Yuto Hozaka, Tetsuya Idichi, Yuko Mataki and Takao Ohtsuka
Cancers 2025, 17(18), 3090; https://doi.org/10.3390/cancers17183090 - 22 Sep 2025
Viewed by 1801
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is a critical disease requiring the development of novel effective therapeutic approaches due to its increasing global incidence and associated low survival rates. While immunotherapy, including immune checkpoint inhibitors, has shown efficacy against various tumors, developing an effective treatment [...] Read more.
Pancreatic ductal adenocarcinoma (PDAC) is a critical disease requiring the development of novel effective therapeutic approaches due to its increasing global incidence and associated low survival rates. While immunotherapy, including immune checkpoint inhibitors, has shown efficacy against various tumors, developing an effective treatment approach for PDAC poses a challenge. This is primarily attributed to the complex and distinctive immune evasion mechanisms of PDAC. Recent studies have revealed that tumor-associated macrophages (TAMs) play a crucial role in enhancing immune evasion in PDAC. This role is mediated through multiple pathways, including cytokine secretion and the activation or suppression of diverse immune cells. A clear understanding of how macrophages contribute to PDAC proliferation could lead to the development of novel immune therapy approaches targeting TAMs. In this review, we summarized the multifaceted activities and roles of TAMs in PDAC and explored the potential effect of immunotherapeutic approaches on PDAC, with a particular focus on chimeric antigen receptor (CAR) macrophages. This review was based on promising findings from recent studies on CAR macrophage-based immunotherapy for solid tumors. Full article
(This article belongs to the Special Issue Novel Diagnosis and Treatment Approaches in Pancreatic Cancer)
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21 pages, 561 KB  
Review
Postoperative Acute Pancreatitis After Pancreatic Resections—A Narrative Review and a Diagnostic Algorithm
by Ewa Grudzińska and Magdalena Gajda
Cancers 2025, 17(17), 2773; https://doi.org/10.3390/cancers17172773 - 26 Aug 2025
Viewed by 2011
Abstract
Pancreatic cancer is one of the deadliest tumors, and surgery is, for now, the only potentially curative treatment. However, pancreatic surgery is burdened with severe complications, of which postoperative pancreatic fistula (POPF) is one of the most dangerous. Recent publications show that there [...] Read more.
Pancreatic cancer is one of the deadliest tumors, and surgery is, for now, the only potentially curative treatment. However, pancreatic surgery is burdened with severe complications, of which postoperative pancreatic fistula (POPF) is one of the most dangerous. Recent publications show that there is a strong connection between POPF and postoperative acute pancreatitis (POAP). In this review, we present the available literature on PPAP, summarizing the available diagnostic, prophylactic, and treatment tools. We identify POAP as a specific postoperative complication where a lack of unified definitions and treatment guidelines makes both research and clinical decisions more difficult. Based on the available studies, we also propose an algorithm for early POAP detection. Full article
(This article belongs to the Special Issue Novel Diagnosis and Treatment Approaches in Pancreatic Cancer)
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Other

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36 pages, 606 KB  
Systematic Review
Failure to Rescue After Surgery for Pancreatic Cancer: A Systematic Review and Narrative Synthesis of Risk Factors and Safety Strategies
by Masashi Uramatsu, Yoshikazu Fujisawa, Paul Barach, Hiroaki Osakabe, Moe Matsumoto and Yuichi Nagakawa
Cancers 2025, 17(19), 3259; https://doi.org/10.3390/cancers17193259 - 8 Oct 2025
Viewed by 1505
Abstract
Background: Failure to rescue (FTR), defined as death after major postoperative complications, is a critical quality indicator in pancreatic cancer surgery. Despite advances in surgical techniques and perioperative care, FTR rates remain high and vary across institutions. Methods: This systematic review [...] Read more.
Background: Failure to rescue (FTR), defined as death after major postoperative complications, is a critical quality indicator in pancreatic cancer surgery. Despite advances in surgical techniques and perioperative care, FTR rates remain high and vary across institutions. Methods: This systematic review uses a narrative synthesis followed by PRISMA 2020. A PubMed search (1992–2025) identified 83 studies; after screening, 52 studies (2010–2025) were included. Eligible designs were registry-based, multicenter, single-center, or prospective audits. Given substantial heterogeneity in study designs, FTR definitions, and outcome measures, a narrative synthesis was performed; no formal risk-of-bias assessment or meta-analysis was conducted. Results: Definitions of FTR varied (in-hospital, 30-day, 90-day, severity-based, and complication-specific cases). Reported rates differed by definition: average reported rates were 13.2% for 90-day CD ≥ III (G1); 10.3% for in-hospital/30-day CD ≥ III (G3); and 7.4% for 30-day “serious/major” morbidity (G8). Absolute differences were +3.0 and +2.9 percentage points (exploratory, descriptive comparisons). Five domains were consistently associated with lower FTR: (i) centralization to high-volume centers; (ii) safe adoption/refinement of surgical techniques; (iii) optimized perioperative management including early imaging and structured escalation pathways; (iv) patient-level risk stratification and prehabilitation; and (v) non-technical skills (NTSs) such as decision-making, situational awareness, communication, teamwork, and leadership. Among NTS domains, stress and fatigue management were not addressed in any included study. Limitations: Evidence is predominantly observational with substantial heterogeneity in study designs and FTR definitions; the search was limited to PubMed; and no formal risk-of-bias, publication-bias assessment, or meta-analysis was performed. Consequently, estimates and associations are descriptive/associative with limited certainty and generalizability. Conclusions: NTSs were rarely used or measured across the included studies, with validated instruments; quantitative assessment was uncommon, and no study evaluated stress or fatigue management. Reducing the FTR after pancreatic surgery will require standardized, pancreas-specific definitions of FTR, process-level rescue metrics, and deliberate strengthening of NTS. We recommend a pancreas-specific operational definition with an explicit numerator/denominator: numerator = all-cause mortality within 90 days of surgery; denominator = patients who experience major complications (Clavien–Dindo grade III–V, often labeled “CD ≥ 3”). Addressing the gaps in stress and fatigue management and embedding behavioral metrics into quality improvement programs are critical next steps to reduce preventable mortality after complex pancreatic cancer procedures. Full article
(This article belongs to the Special Issue Novel Diagnosis and Treatment Approaches in Pancreatic Cancer)
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