Mechanisms of cancer cell death: Therapeutic implications for pancreatic ductal adenocarcinoma

Pancreatic ductal adenocarcinoma (PDAC) is a type of cancer that is strongly associated with poor prognosis and short median survival times. In stark contrast to the progress seen in other cancer types in recent decades, discoveries of new treatments in PDAC have been few and far between and there h...

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Main Authors: Pook, H, Pauklin, S
Format: Journal article
Language:English
Published: MDPI 2021
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author Pook, H
Pauklin, S
author_facet Pook, H
Pauklin, S
author_sort Pook, H
collection OXFORD
description Pancreatic ductal adenocarcinoma (PDAC) is a type of cancer that is strongly associated with poor prognosis and short median survival times. In stark contrast to the progress seen in other cancer types in recent decades, discoveries of new treatments in PDAC have been few and far between and there has been little improvement in overall survival (OS). The difficulty in treating this disease is multifactorial, contributed to by late presentation, difficult access to primary tumour sites, an ‘immunologically cold’ phenotype, and a strong tendency of recurrence likely driven by cancer stem cell (CSC) populations. Furthermore, apparently contrasting roles of tumour components (such as fibrotic stroma) and intracellular pathways (such as autophagy and TGFβ) have made it difficult to distinguish beneficial from detrimental drug targets. Despite this, progress has been made in the field, including the determination of mFOLFIRINOX as the standard-of-care adjuvant therapy and the discovery of KRASG12C mutant inhibitors. Moreover, new research, as outlined in this review, has highlighted promising new approaches including the targeting of the tumour microenvironment, enhancement of immunotherapies, epigenetic modulation, and destruction of CSCs.
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spelling oxford-uuid:d32a9043-ca48-4b86-ae21-709ef76bad032022-03-27T08:09:24ZMechanisms of cancer cell death: Therapeutic implications for pancreatic ductal adenocarcinomaJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:d32a9043-ca48-4b86-ae21-709ef76bad03EnglishSymplectic ElementsMDPI2021Pook, HPauklin, SPancreatic ductal adenocarcinoma (PDAC) is a type of cancer that is strongly associated with poor prognosis and short median survival times. In stark contrast to the progress seen in other cancer types in recent decades, discoveries of new treatments in PDAC have been few and far between and there has been little improvement in overall survival (OS). The difficulty in treating this disease is multifactorial, contributed to by late presentation, difficult access to primary tumour sites, an ‘immunologically cold’ phenotype, and a strong tendency of recurrence likely driven by cancer stem cell (CSC) populations. Furthermore, apparently contrasting roles of tumour components (such as fibrotic stroma) and intracellular pathways (such as autophagy and TGFβ) have made it difficult to distinguish beneficial from detrimental drug targets. Despite this, progress has been made in the field, including the determination of mFOLFIRINOX as the standard-of-care adjuvant therapy and the discovery of KRASG12C mutant inhibitors. Moreover, new research, as outlined in this review, has highlighted promising new approaches including the targeting of the tumour microenvironment, enhancement of immunotherapies, epigenetic modulation, and destruction of CSCs.
spellingShingle Pook, H
Pauklin, S
Mechanisms of cancer cell death: Therapeutic implications for pancreatic ductal adenocarcinoma
title Mechanisms of cancer cell death: Therapeutic implications for pancreatic ductal adenocarcinoma
title_full Mechanisms of cancer cell death: Therapeutic implications for pancreatic ductal adenocarcinoma
title_fullStr Mechanisms of cancer cell death: Therapeutic implications for pancreatic ductal adenocarcinoma
title_full_unstemmed Mechanisms of cancer cell death: Therapeutic implications for pancreatic ductal adenocarcinoma
title_short Mechanisms of cancer cell death: Therapeutic implications for pancreatic ductal adenocarcinoma
title_sort mechanisms of cancer cell death therapeutic implications for pancreatic ductal adenocarcinoma
work_keys_str_mv AT pookh mechanismsofcancercelldeaththerapeuticimplicationsforpancreaticductaladenocarcinoma
AT pauklins mechanismsofcancercelldeaththerapeuticimplicationsforpancreaticductaladenocarcinoma