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Pancreatic Ductal Adenocarcinoma: New Therapeutic Strategies
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Pancreatic Ductal Adenocarcinoma: New Therapeutic Strategies

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

Deadline for manuscript submissions: closed (10 June 2022) | Viewed by 5926

Special Issue Editor

Dr. Kenji Fujiwara

E-Mail Website
Guest Editor
1. Department of Surgery, Sada Hospital, 2-4-28 Watanabe St, Chuo Ward, Fukuoka 810-0004, Japan
2. Collaborative researcher in the Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi Ward, Fukuoka 812-8582, Japan
Interests: pancreatic cancer; gastrointestinal surgery; tumor microenvironment; immunotherapy; bioinformatics

Special Issue Information

Dear Colleagues,

In spite of great advances in medical science, pancreatic ductal adenocarcinoma (PDAC) still carries a very poor prognosis. The recent success of immunotherapy, including immune checkpoint inhibitors, still cannot change this miserable condition of patients. In order to generate new strategies, we need to collect and combine our knowledge of not only clinical experience but also basic science.

We welcome the submission of original and review articles on basic and clinical research on the following topics:

  1. Recent advances in therapeutic approaches including surgery, radiotherapy, and chemotherapy;
  2. Immunology and immunotherapy in PDAC;
  3. Biomarkers for diagnosis and estimating prognosis;
  4. Molecular mechanisms implicated in the tumor microenvironment;
  5. Induction of artificial intelligence to the diagnosis and treatment;
  6. Contribution from bioinformatics to PDAC.

Dr. Kenji Fujiwara
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 short 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. Journal of Clinical Medicine 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 2600 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

  • tumor microenvironment
  • bioinformatics
  • artificial intelligence
  • surgical approach
  • chemotherapy
  • immunotherapy
  • radiotherapy
  • combination therapy

Published Papers (3 papers)

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Research

10 pages, 664 KiB  
Article
The Prognostic and Predictive Role of the Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Lymphocyte-to-Monocyte Ratio (LMR) as Biomarkers in Resected Pancreatic Cancer
by Sarah Maloney, Nick Pavlakis, Malinda Itchins, Jennifer Arena, Anubhav Mittal, Amanda Hudson, Emily Colvin, Sumit Sahni, Connie Diakos, David Chan, Anthony J. Gill, Jaswinder Samra and Stephen J. Clarke
J. Clin. Med. 2023, 12(5), 1989; https://doi.org/10.3390/jcm12051989 - 02 Mar 2023
Cited by 8 | Viewed by 1565
Abstract
Pancreatic cancer has poor survival despite modern-day advances in its management. At present, there are no available biomarkers that can predict chemotherapy response or help inform prognosis. In more recent years, there has been increased interest in potential inflammatory biomarkers, with studies revealing [...] Read more.
Pancreatic cancer has poor survival despite modern-day advances in its management. At present, there are no available biomarkers that can predict chemotherapy response or help inform prognosis. In more recent years, there has been increased interest in potential inflammatory biomarkers, with studies revealing a worse prognosis of patients with a higher neutrophil-to-lymphocyte ratio in a range of tumour types. Our aim was to assess the role of three inflammatory biomarkers in peripheral blood in predicting chemotherapy response in patients with earlier disease treated with neoadjuvant chemotherapy and as a prognostic marker in all patients that underwent surgery for pancreatic cancer. Using retrospective records, we discovered that patients with a higher neutrophil-to-lymphocyte ratio (>5) at the time of diagnosis had worse median overall survival than those with ratios ≤5 at 13 and 32.4 months (p = 0.001, HR 2.43), respectively. We were able to appreciate a correlation between a higher platelet-to-lymphocyte ratio and increased residual tumour in the histopathological specimen in patients receiving neoadjuvant chemotherapy; however, the association was weak (p = 0.03, coefficient 0.21). Due to the dynamic relationship between the immune system and pancreatic cancer, it is unsurprising that immune markers may be useful as potential biomarkers; however, larger prospective studies are needed to validate these findings. Full article
(This article belongs to the Special Issue Pancreatic Ductal Adenocarcinoma: New Therapeutic Strategies)
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12 pages, 2053 KiB  
Article
Clinical Outcomes of Conversion Surgery after FOLFIRINOX in Patients with Unresectable Advanced Pancreatic Cancer: A Retrospective Cohort Study at a Single Center
by Naoki Mita, Takuji Iwashita, Hironao Ichikawa, Yuhei Iwasa, Shinya Uemura, Katsutoshi Murase and Masahito Shimizu
J. Clin. Med. 2021, 10(13), 2848; https://doi.org/10.3390/jcm10132848 - 27 Jun 2021
Cited by 1 | Viewed by 1893
Abstract
Pancreatic cancer is one of the most lethal cancers. To improve its prognosis, conversion surgery for initially unresectable advanced pancreatic cancer (UAPC) after chemotherapy has been reported in recent years. Methods: A retrospective analysis of the patients with initially UAPC underwent conversion surgery [...] Read more.
Pancreatic cancer is one of the most lethal cancers. To improve its prognosis, conversion surgery for initially unresectable advanced pancreatic cancer (UAPC) after chemotherapy has been reported in recent years. Methods: A retrospective analysis of the patients with initially UAPC underwent conversion surgery after the first-line modified FOLFIRINOX (mFX) was conducted at a single tertiary care center between January 2014 and March 2020. Results: Among 79 patients with UAPC who had mFX, 8 patients with a median age of 63 years, including 5 males (3 with locally advanced and 5 metastatic lesions), underwent conversion surgery after a median of 20 cycles of mFX. Conversion surgery was performed in 10.1% of patients (8/79) and surgical resection was successful in all with R0 resection. Postoperative major adverse events were seen in 2 patients, but no perioperative deaths were recognized. Recurrence was confirmed in 3 patients, and these 3 patients died due to cancer recurrence in 17.7, 30.6 and 57.8 months after mFX initiation. 5 patients were still alive without recurrence. The median OS in the patients who underwent conversion surgery was estimated as 65.9 months and was significantly longer than that of the patients without conversion surgery or that in the patients who had a partial response for mFX but did not have conversion surgery. The median follow-up period for the patients who had conversion surgery was 35.2 months. Conclusion: Conversion surgery achieved long-term survival in patients with UAPC who were treated with the first-line mFX, although controversy still remained. Full article
(This article belongs to the Special Issue Pancreatic Ductal Adenocarcinoma: New Therapeutic Strategies)
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12 pages, 948 KiB  
Article
Optimal Upfront Treatment in Surgically Resectable Pancreatic Cancer Candidates: A High-Volume Center Retrospective Analysis
by Sarah Maloney, Malinda Itchins, Jennifer Arena, Sumit Sahni, Viive M. Howell, Sarah A. Hayes, Anthony J. Gill, Stephen J. Clarke, Jaswinder Samra, Anubhav Mittal and Nick Pavlakis
J. Clin. Med. 2021, 10(12), 2700; https://doi.org/10.3390/jcm10122700 - 18 Jun 2021
Cited by 5 | Viewed by 1707
Abstract
Pancreatic adenocarcinoma is a devastating disease with only 15–20% of patients resectable at diagnosis. Neoadjuvant chemotherapy for this cohort is becoming increasingly popular; however, there are no published randomized trials that support the use of neoadjuvant chemotherapy over upfront surgery in resectable disease. [...] Read more.
Pancreatic adenocarcinoma is a devastating disease with only 15–20% of patients resectable at diagnosis. Neoadjuvant chemotherapy for this cohort is becoming increasingly popular; however, there are no published randomized trials that support the use of neoadjuvant chemotherapy over upfront surgery in resectable disease. This retrospective cohort analysis was conducted to compare both treatment pathways and to identify any potential prognostic markers. Medical records from one large volume pancreatic cancer center from 2013–2019 were reviewed and 126 patients with upfront resectable disease were analyzed. Due to a change in practice in our center patients treated prior to December 2016 received upfront surgery and those treated after this date received neoadjuvant chemotherapy. Of these, 86 (68%) patients were treated with upfront surgery and 40 (32%) of patients were treated with neoadjuvant chemotherapy. Our results demonstrated that patients treated with upfront surgery with early-stage (1a) disease had a longer median OS compared to those treated with neoadjuvant chemotherapy (24 vs. 21 months, p = 0.028). This survival difference was not evident for all patients (regardless of stage). R0 resections were similar between groups (p = 0.605). We identified that both tumor viability (in neoadjuvant chemotherapy-treated patients) and tumor grade were useful prognostic markers. Upfront surgery for certain patients with low volume disease may be suitable despite the global trend towards neoadjuvant chemotherapy for all upfront resectable patients. A prospective clinical trial in this cohort incorporating biomarkers is needed to determine optimal therapy pathway. Full article
(This article belongs to the Special Issue Pancreatic Ductal Adenocarcinoma: New Therapeutic Strategies)
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