Pancreatic Cancer: Advances in Treatment and Future Prospects

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: 20 July 2025 | Viewed by 762

Special Issue Editors


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Guest Editor
Research Unit of General Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
Interests: colorectal cancer; colorectal surgery; pancreatic cancer; pancreatic surgery; hepato-pancreato-biliary (HPB) surgery; robotic surgery
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Guest Editor Assistant
Operative Research Unit of General Surgery, Fondazione Policlinico Universitario, Campus Bio-Medico, 00128 Rome, Italy
Interests: pancreatic cancer; pancreatic surgery; HPB surgery; robotic surgery

Special Issue Information

Dear Colleagues,

Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies, characterized by an aggressive biological profile, late-stage diagnosis, and limited response to existing therapies. Despite significant advancements in our understanding of the molecular and cellular biology of PDAC, its prognosis continues to be poor, with a five-year survival rate of less than 10%. These outcomes are largely driven by the tumor’s complex biology, its propensity for early dissemination, and the challenges in achieving timely diagnosis.

Recent research has provided critical insights into the genetic and molecular landscape of PDAC, offering new opportunities for early detection and targeted therapies. Biomarkers for early diagnosis and risk stratification are an area of active exploration, with the potential to identify patients at earlier, more treatable stages of the disease. Surgical resection remains the cornerstone of curative treatment, yet it is only feasible in a minority of cases due to late-stage presentation. Advances in surgical techniques, including minimally invasive and robotic approaches, aim to optimize patient outcomes while minimizing perioperative morbidity. Moreover, managing postoperative complications, such as pancreatic fistulas, remains a key challenge in improving recovery and long-term survival.

Neoadjuvant and adjuvant therapies are increasingly being integrated into the standard of care, offering opportunities to downstage borderline resectable tumors and enhance the effectiveness of surgery. However, the optimal sequencing, combination, and personalization of these therapies are subjects of ongoing research and debate.

This Special Issue of Medicina focuses on the intersection of tumor biology, early detection, surgical innovation, and multimodal therapy in pancreatic cancer. We aim to highlight cutting-edge research and clinical advances in the following areas:

  • Tumor biology and the genetic and molecular mechanisms driving PDAC progression;
  • Biomarkers and novel strategies for early diagnosis and risk stratification;
  • Innovations in surgical techniques, including robotic and minimally invasive approaches;
  • Management and prevention of postoperative complications;
  • Advances in neoadjuvant and adjuvant therapy protocols and their integration into clinical practice.

By gathering contributions from leading experts, this Special Issue seeks to provide a deeper understanding of the disease and its management, with the ultimate goal of improving early detection and optimizing therapeutic strategies to enhance patient outcomes.

Dr. Damiano Caputo
Guest Editor

Dr. Roberto Cammarata
Guest Editor Assistant

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Keywords

  • pancreatic cancer
  • pancreatic ductal adenocarcinoma (PDAC)
  • biomarkers
  • neoadjuvant therapy
  • adjuvant therapy
  • robotic surgery
  • minimally invasive surgery
  • precision medicine
  • multidisciplinary care
  • post-operative complications

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Published Papers (1 paper)

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14 pages, 356 KiB  
Systematic Review
Improving Outcomes in Pancreatic Adenocarcinoma: A Systematic Review of Immunotherapy in Multimodal Treatment
by Paul-Cristian Borz, Mihnea Bogdan Borz, Oliviu-Cristian Borz, Toader Zaharie, Claudia Hagiu, Lidia Munteanu and Simona Gurzu
Medicina 2025, 61(6), 1076; https://doi.org/10.3390/medicina61061076 - 11 Jun 2025
Viewed by 424
Abstract
Background: Despite advances in chemotherapy and supportive care, pancreatic ductal adenocarcinoma (PDAC) continues to carry a dismal prognosis, with a five-year survival rate of approximately 13%. While immunotherapy has revolutionized treatment for several malignancies, its efficacy in PDAC remains limited. Recent research [...] Read more.
Background: Despite advances in chemotherapy and supportive care, pancreatic ductal adenocarcinoma (PDAC) continues to carry a dismal prognosis, with a five-year survival rate of approximately 13%. While immunotherapy has revolutionized treatment for several malignancies, its efficacy in PDAC remains limited. Recent research has shifted focus toward integrating immunotherapy with chemotherapy, radiation, and targeted therapies in an effort to overcome therapeutic resistance and improve outcomes. Ongoing clinical trials are actively investigating these multimodal strategies. Materials and Methods: A systematic search was conducted using PubMed and ScienceDirect to identify relevant studies published in the past six years. Search terms included “pancreatic adenocarcinoma immunotherapy,” “pancreatic cancer treatments,” and “combination treatments for pancreatic adenocarcinoma.” Only English-language articles were included. Results: A total of 126 articles were initially identified through the database search. After a full-text screening, 48 articles were deemed potentially relevant. Following a rigorous review, 11 studies met the inclusion criteria and were selected for analysis. These studies included randomized controlled trials, non-randomized controlled trials, and retrospective studies. Meta-analyses and case reports were excluded. Articles that failed to meet the inclusion criteria were excluded, primarily due to the absence of relevant data addressing the main objective of this review. Conclusions: Combination strategies with immunotherapy and chemotherapy offer modest survival gains in metastatic settings, yet efforts in resectable and borderline resectable disease have fallen short. These outcomes reflect the profound immunosuppressive forces of the PDAC microenvironment. A new era of treatment must move beyond broad immunotherapeutic applications toward a precision-driven model. Molecular markers, such as KRAS mutations and circulating tumor DNA (ctDNA) profiles, are beginning to illuminate paths for personalized therapy selection. Future progress will depend on biomarker-guided clinical trials, a deeper understanding of immune resistance mechanisms, and bold innovation at the intersection of immunology and tumor biology. Full article
(This article belongs to the Special Issue Pancreatic Cancer: Advances in Treatment and Future Prospects)
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