Letter to the Editor
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 14, 2022; 28(22): 2523-2526
Published online Jun 14, 2022. doi: 10.3748/wjg.v28.i22.2523
Future therapies for pancreatic carcinoma: Insights into cancer precision medicine
Qiu-Yu Jiang, Zhi-Xue Chen, Si Zhang, Ru-Yi Xue
Qiu-Yu Jiang, Zhi-Xue Chen, Ru-Yi Xue, Department of Gastroenterology and Hepatology, Zhongshan Hospital, Shanghai Institute of Liver Disease, Fudan University, Shanghai 200032, China
Si Zhang, NHC Key Laboratory of Glycoconjugate Research, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai 200032, China
Author contributions: Jiang QY and Chen ZX wrote the original draft; Xue RY conceptualized and reviewed the manuscript; Zhang S edited and revised the manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ru-Yi Xue, MD, PhD, Associate Chief Physician, Department of Gastroenterology and Hepatology, Zhongshan Hospital, Shanghai Institute of Liver Disease, Fudan University, No. 180 Fenglin Road, Shanghai 200032, China. xue.ruyi@zs-hospital.sh.cn
Received: November 4, 2021
Peer-review started: November 4, 2021
First decision: December 26, 2021
Revised: January 9, 2022
Accepted: April 28, 2022
Article in press: April 28, 2022
Published online: June 14, 2022
Abstract

Pancreatic carcinoma (PC) has one of the highest rates of cancer-related death worldwide. Except for surgery, adjuvant chemotherapy, chemoradiotherapy, and immunotherapy have shown various efficacies depending on the stage of the patient. We read the review “Current and emerging therapeutic strategies in pancreatic cancer: Challenges and opportunities” and offer some opinions that may improve its precision and completeness. This review presents a map of appropriate therapies for PC at different stages. Based on the clinical trial outcomes mentioned in the review, we evaluated the potential therapeutic options for PC and helped explain the contradictory efficacy between different programmed cell death protein 1/programmed cell death ligand 1 clinical trials, which may have resulted from the unique features of PC. Although R0 resection and adjuvant chemotherapy are still the gold standards for PC, new modalities, with or without clinical validation, are needed to establish more specific and precise treatments for PC.

Keywords: Pancreatic carcinoma, Immunotherapy, Chemotherapy, Radiochemotherapy, Future therapies

Core Tip: For the treatment of pancreatic carcinoma (PC), although surgery with adjuvant chemotherapy or chemoradiotherapy remains the gold standard for most patients, attention needs to be given to immunotherapy and other research hotspots. In addition to programmed cell death protein 1/programmed cell death ligand 1, we suggest that immunotherapies such as agonistic CD40, adoptive T cell therapy, myeloid-targeted therapies, stroma-targeted therapies, multiple immunomodulatory agents, and other treatments such as small-molecule inhibitors, antibodies, or viruses targeting tumors, as well as gene editing techniques, may help improve the prognosis of patients with PC in the future.