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Pancreatic cancer

The Lancet (British edition), 2020-06, Vol.395 (10242), p.2008-2020 [Peer Reviewed Journal]

2020 Elsevier Ltd ;2020. Elsevier Ltd ;ISSN: 0140-6736 ;EISSN: 1474-547X ;DOI: 10.1016/S0140-6736(20)30974-0

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Title:
Pancreatic cancer
Author: Mizrahi, Jonathan D ; Surana, Rishi ; Valle, Juan W ; Shroff, Rachna T
Subjects: 5-Fluorouracil ; Age ; BRCA1 protein ; Cancer ; Cell cycle ; Chemotherapy ; Computed tomography ; Cyclin-dependent kinases ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diagnostic systems ; Endoscopes ; Epidemiology ; Family medical history ; Folinic acid ; Gemcitabine ; Gene expression ; Genetics ; Health risk assessment ; Health risks ; Intravenous administration ; Irinotecan ; Kinases ; Medical prognosis ; Medical research ; Medical treatment ; Metastases ; Mutation ; Oxaliplatin ; Paclitaxel ; Pancreatic cancer ; Pancreatitis ; Poly(ADP-ribose) polymerase ; Risk analysis ; Risk factors ; Signs and symptoms ; Smoking ; Survival ; Tobacco ; Tumors ; Ultrasound
Is Part Of: The Lancet (British edition), 2020-06, Vol.395 (10242), p.2008-2020
Description: Pancreatic cancer is a highly fatal disease with a 5-year survival rate of approximately 10% in the USA, and it is becoming an increasingly common cause of cancer mortality. Risk factors for developing pancreatic cancer include family history, obesity, type 2 diabetes, and tobacco use. Patients typically present with advanced disease due to lack of or vague symptoms when the cancer is still localised. High quality computed tomography with intravenous contrast using a dual phase pancreatic protocol is typically the best method to detect a pancreatic tumour and to determine surgical resectability. Endoscopic ultrasound is an increasingly used complementary staging modality which also allows for diagnostic confirmation when combined with fine needle aspiration. Patients with pancreatic cancer are often divided into one of four categories based on extent of disease: resectable, borderline resectable, locally advanced, and metastatic; patient condition is also an important consideration. Surgical resection represents the only chance for cure, and advancements in adjuvant chemotherapy have improved long-term outcomes in these patients. Systemic chemotherapy combinations including FOLFIRINOX (5-fluorouracil, folinic acid [leucovorin], irinotecan, and oxaliplatin) and gemcitabine plus nab-paclitaxel remain the mainstay of treatment for patients with advanced disease. Data on the benefit of PARP inhibition as maintenance therapy in patients with germline BRCA1 or BRACA2 mutations might prove to be a harbinger of advancement in targeted therapy. Additional research efforts are focusing on modulating the pancreatic tumour microenvironment to enhance the efficacy of the immunotherapeutic strategies.
Publisher: London: Elsevier Ltd
Language: English
Identifier: ISSN: 0140-6736
EISSN: 1474-547X
DOI: 10.1016/S0140-6736(20)30974-0
Source: ProQuest One Psychology
AUTh Library subscriptions: ProQuest Central

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Pancreatic cancer

2020 Elsevier Ltd ;2020. Elsevier Ltd ;ISSN: 0140-6736 ;EISSN: 1474-547X ;DOI: 10.1016/S0140-6736(20)30974-0

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