Multidisciplinary standards of care and recent progress in pancreatic ductal adenocarcinoma

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  • Aaron J. Grossberg
    Department of Radiation Medicine Oregon Health & Science University Portland Oregon
  • Linda C. Chu
    The Russell H. Morgan Department of Radiology and Radiological Science Johns Hopkins University School of Medicine Baltimore Maryland
  • Christopher R. Deig
    Department of Radiation Medicine Oregon Health & Science University Portland Oregon
  • Eliot K. Fishman
    The Russell H. Morgan Department of Radiology and Radiological Science Johns Hopkins University School of Medicine Baltimore Maryland
  • William L. Hwang
    Department of Radiation Oncology Massachusetts General Hospital Boston Massachusetts
  • Anirban Maitra
    Department of Pathology Sheikh Ahmed Pancreatic Cancer Research Center The University of Texas MD Anderson Cancer Center Houston Texas
  • Daniel L. Marks
    Brenden‐Colson Center for Pancreatic Care Oregon Health & Science University Portland Oregon
  • Arnav Mehta
    Broad Institute of Harvard Cambridge Massachusetts
  • Nima Nabavizadeh
    Department of Radiation Medicine Oregon Health & Science University Portland Oregon
  • Diane M. Simeone
    Department of Surgery Perlmutter Cancer Center New York University Langone Health New York New York
  • Colin D. Weekes
    Division of Hematology/Oncology Department of Medicine Massachusetts General Hospital Harvard Medical School Boston Massachusetts
  • Charles R. Thomas
    Department of Radiation Medicine Oregon Health & Science University Portland Oregon

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<jats:title>Abstract</jats:title><jats:p>Despite tremendous gains in the molecular understanding of exocrine pancreatic cancer, the prognosis for this disease remains very poor, largely because of delayed disease detection and limited effectiveness of systemic therapies. Both incidence rates and mortality rates for pancreatic cancer have increased during the past decade, in contrast to most other solid tumor types. Recent improvements in multimodality care have substantially improved overall survival, local control, and metastasis‐free survival for patients who have localized tumors that are amenable to surgical resection. The widening gap in prognosis between patients with resectable and unresectable or metastatic disease reinforces the importance of detecting pancreatic cancer sooner to improve outcomes. Furthermore, the developing use of therapies that target tumor‐specific molecular vulnerabilities may offer improved disease control for patients with advanced disease. Finally, the substantial morbidity associated with pancreatic cancer, including wasting, fatigue, and pain, remains an under‐addressed component of this disease, which powerfully affects quality of life and limits tolerance to aggressive therapies. In this article, the authors review the current multidisciplinary standards of care in pancreatic cancer with a focus on emerging concepts in pancreatic cancer detection, precision therapy, and survivorship.</jats:p>

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