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Pancreatic Cancer: Novel Strategies of Diagnosis and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 26 August 2025 | Viewed by 627

Special Issue Editors


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Guest Editor
1. Faculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania
2. Department of Internal Medicine, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania
3. Academy of Romanian Scientists, 050085 Bucharest, Romania
Interests: interdisciplinarity; comorbidities; cancer; molecular diagnostics; personalized treatments
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
1. Faculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania
2. Department of Internal Medicine, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania
Interests: pancreatic cancer; molecular diagnostics; liquid biopsy; proteomics; genomics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Pancreatic cancer is widely recognized as a highly aggressive form of cancer, exhibiting a 5-year survival rate of approximately 10%. The unfavorable prognosis primarily stems from delayed diagnosis during therapeutically advanced stages, as well as the poor success rate of oncological treatments. Recent research has concentrated on identifying potential non-invasive biomarkers that can be utilized to diagnose these patients at an early stage, evaluate their prognosis, and develop new therapeutic strategies. To date, a number of proteomic biomarkers, free-cell DNA, and microRNA have exhibited encouraging outcomes. Notwithstanding these findings, no biomarker has received approval for utilization in present-day practice.

A further crucial factor is the low incidence of pancreatic cancer, which, from a cost–benefit standpoint, precludes the implementation of screening strategies in the general population. Conversely, the recommended screening methods for specific subgroups with a significant likelihood of developing pancreatic cancer entail assessment using endoscopic ultrasound or magnetic resonance imaging, resulting in elevated expenses. Therefore, we highlight the importance of identifying non-invasive biomarkers that possess both high diagnostic accuracy and incur reasonable costs for monitoring these patients. MicroRNAs play a vital role in biological processes such as cell survival, apoptosis and proliferation, invasion, metastasis, and drug response, which highlights their potential as targets for diagnosis, prognosis, and therapy in patients with malignant disease. Furthermore, there is limited knowledge regarding the intercellular communication that is mediated by microRNA in pancreatic cancer. Researching the molecular changes that occur during the sequential progression from a premalignant lesion, such as pancreatic intraepithelial neoplasia or intraductal papillary mucinous neoplasm, to pancreatic cancer will help us better comprehend the pancreatic oncogenesis process. Additionally, the connection between molecular marker values and clinical characteristics could help find biomarkers that can effectively identify people who are more likely to suffer from pancreatic cancer. This would enable the application of screening strategies in these groups.

The primary focus of this Special Issue is to increase the clinical focus on the pathogenesis of pancreatic cancer in order to achieve progress in innovative diagnostic and treatment strategies. We therefore want to provide novel data on patients who are diagnosed with pancreatic cancer, as well as those who possess risk factors associated with the development of this malignant condition.

Yours faithfully,

Dr. Camelia Cristina Diaconu
Dr. Gina Gheorghe
Guest Editors

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Keywords

  • pancreatic cancer
  • chronic pancreatitis
  • pancreatic intraepithelial neoplasia
  • gastroenterology
  • clinical innovative diagnostic
  • clinical treatment strategies

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Published Papers (1 paper)

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Review

18 pages, 3877 KiB  
Review
The Palliation of Unresectable Pancreatic Cancer: Evolution from Surgery to Minimally Invasive Modalities
by Muaaz Masood, Shayan Irani, Mehran Fotoohi, Lauren Wancata, Rajesh Krishnamoorthi and Richard A. Kozarek
J. Clin. Med. 2025, 14(14), 4997; https://doi.org/10.3390/jcm14144997 - 15 Jul 2025
Viewed by 383
Abstract
Pancreatic cancer is an aggressive malignancy, with a current 5-year survival rate in the United States of approximately 13.3%. Although the current standard for resectable pancreatic cancer most commonly includes neoadjuvant chemotherapy prior to a curative resection, surgery, in the majority of patients, [...] Read more.
Pancreatic cancer is an aggressive malignancy, with a current 5-year survival rate in the United States of approximately 13.3%. Although the current standard for resectable pancreatic cancer most commonly includes neoadjuvant chemotherapy prior to a curative resection, surgery, in the majority of patients, has historically been palliative. The latter interventions include open or laparoscopic bypass of the bile duct or stomach in cases of obstructive jaundice or gastric outlet obstruction, respectively. Non-surgical interventional therapies started with percutaneous transhepatic biliary drainage (PTBD), both as a palliative maneuver in unresectable patients with obstructive jaundice and to improve liver function in patients whose surgery was delayed. Likewise, interventional radiologic techniques included the placement of plastic and ultimately self-expandable metal stents (SEMSs) through PTBD tracts in patients with unresectable cancer as well as percutaneous cholecystostomy in patients who developed cholecystitis in the context of malignant obstructive jaundice. Endoscopic retrograde cholangiopancreatography (ERCP) and stent placement (plastic/SEMS) were subsequently used both preoperatively and palliatively, and this was followed by, or undertaken in conjunction with, endoscopic gastro-duodenal SEMS placement for gastric outlet obstruction. Although endoscopic ultrasound (EUS) was initially used to cytologically diagnose and stage pancreatic cancer, early palliation included celiac block or ablation for intractable pain. However, it took the development of lumen-apposing metal stents (LAMSs) to facilitate a myriad of palliative procedures: cholecystoduodenal, choledochoduodenal, gastrohepatic, and gastroenteric anastomoses for cholecystitis, obstructive jaundice, and gastric outlet obstruction, respectively. In this review, we outline these procedures, which have variably supplanted surgery for the palliation of pancreatic cancer in this rapidly evolving field. Full article
(This article belongs to the Special Issue Pancreatic Cancer: Novel Strategies of Diagnosis and Treatment)
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