胰腺癌空间构型与新辅助治疗和根治性切除术后疾病复发相关
Spatial Configuration of Pancreatic Cancer Is Associated with Disease Recurrence after Neoadjuvant Therapy and Curative-Intent Resection.
从标准H&E切片量化的残留癌-间质拓扑结构在PDAC新辅助治疗后产生独立预后信号,为空间风险提供细胞免疫相关性依据,并推动前瞻性验证及空间信息指导的辅助治疗策略。
英文原题:The road to overcome pancreatic cancer: Where are we?
The road to overcome pancreatic cancer: Where are we?
胰腺癌(PC)是一种复杂的恶性肿瘤,预后不良。
胰腺癌(PC)是一种复杂恶性肿瘤,预后不良。在这篇当前领域综述及临床试验趋势分析中,我们探讨胰腺癌临床知识现状和未来研究方向。考虑胰腺导管腺癌(PDAC)的分子生物学时,我们强调胰腺上皮内瘤变(PanIN)在癌变及突变累积中的作用,以及其典型的致密纤维化基质这一独特肿瘤微环境。PC 的突变图谱通常涉及 KRAS、TP53、SMAD4 和 CDKN2A 基因,但具体突变还会因 PDAC 亚型而异。受多种因素影响,目前治疗选择有限:可切除阶段以手术为中心,晚期则采用全身治疗,并可能应用个体化医疗。目前正在开展大量临床试验,研究范围多样,从使用新型或重新定位的化疗药物,到引入新型免疫治疗药物、抗体药物偶联物、TCR-T 细胞治疗,以及研究 mDC3/8-KRAS 癌症疫苗等。
Pancreatic cancer (PC) is an intricate malignancy with poor prognosis. In the present state of the art review paper and clinical trial trend analysis, we explore the current clinically employed state of pancreatic cancer body of knowledge and future research directions. When considering PDACs' molecular biology, we underline the role of PanIN in carcinogenesis and mutational gain, as well as the distinctive tumor microenvironment with the characteristic dense fibrotic stroma. The mutational landscape of PC typically involves KRAS, TP53, SMAD4 and CDKN2A genes, but other mutations can be identified depending on the PDAC subtype. Due to various factors, there are currently limited therapeutic options - from a surgical-centered approach in the resectable stage, to a systemic approach in more advanced stages, including the potential applicability of personalized medicine. Currently, there are numerous clinical trials undergoing that study various landscapes - from the use of newer or repurposed chemotherapeutics, to the introduction of newer immunotherapeutic agents, antibody-drug conjugates, TCR-T cell therapy and the study of mDC3/8-KRAS cancer vaccines, among others.
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