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Pancreatic Cancer: Current Status and Challenges

  • Cancer Chemoprevention (R Agarwal, Section Editor)
  • Published:
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Abstract

Purpose of Review

The 5-year survival rate of patients with pancreatic cancer (PanCA) has remained stagnant. Unfortunately, the incidence is almost equal to mortality rates. These facts underscore the importance of concerted efforts to understand the pathology of this disease. Deregulation of multiple signaling pathways involved in a wide variety of cellular processes including proliferation, apoptosis, invasion, and metastasis contribute not only to cancer development but also to therapeutic resistance. The purpose of this review is to summarize current understanding of etiological factors including emerging evidence on the role of infectious agents, factors associated with therapeutic resistance, and therapeutic options.

Recent Findings

The unique aspect of PanCA is “desmoplasia,” a process that involves proliferation of stromal fibroblasts and collagen deposition in and around the filtrating cancer. Recent studies have identified pancreatic stellate cells (PSCs) as a potential source of such desmoplasia. Biphasic interactions between PSCs and cancer cells, endothelial cells, and/or myeloid-derived suppressor cells in the tumor microenvironment contribute to pancreatic carcinogenesis.

Summary

We summarize limitations of current therapeutic approaches and potential strategies to overcome these limitations using natural products including botanicals as adjuvant/neo-adjuvant for effective management of PanCA.

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Funding

We acknowledge support provided by the CTRC at UTHSA through the NCI support grant no. 2P30 CA 054174-17 (APK) and the CTRC 40th Anniversary Distinguished Professor of Oncology Endowment (APK). This work was supported in part by the funds from Veterans Affairs-Merit Award I01 BX 000766-01 and BX003876; National Center for Complementary and Alternate Medicine 1R01 AT007448 (APK) and National Cancer Institute R01 CA 149516 (RG).

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  1. Jingjing Gong

    Present address: Nanostring Technologies, Inc., 530 Fairview Ave N #2000, Seattle, WA, 98109, USA

Authors and Affiliations

  1. Department of Urology, The University of Texas Health , San Antonio, TX, USA

    Amanda R. Muñoz, Divya Chakravarthy, Rita Ghosh & Addanki P. Kumar

  2. Department of Surgery, The University of Texas Health , San Antonio, TX, USA

    Glenn A. Halff

  3. Department of Molecular Medicine, The University of Texas Health , San Antonio, TX, USA

    Rita Ghosh & Addanki P. Kumar

  4. Department of Pharmacology, The University of Texas Health , San Antonio, TX, USA

    Rita Ghosh & Addanki P. Kumar

  5. UT Health Cancer Center, The University of Texas Health Science Center, San Antonio, TX, USA

    Rita Ghosh & Addanki P. Kumar

  6. South Texas Veterans Health Care System, The University of Texas Health , San Antonio, TX, USA

    Addanki P. Kumar

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  1. Amanda R. Muñoz
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  2. Divya Chakravarthy
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Correspondence to Addanki P. Kumar.

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This article is part of the Topical Collection on Cancer Chemoprevention

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Muñoz, A.R., Chakravarthy, D., Gong, J. et al. Pancreatic Cancer: Current Status and Challenges. Curr Pharmacol Rep 3, 396–408 (2017). https://doi.org/10.1007/s40495-017-0112-3

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