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Future approaches of pancreatic ductal adenocarcinoma

Dr Alfredo Carrato, Head of medical Oncology, Ramón y Cajal University Hospital, Madrid, Spain
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Date: 14.10.2020 at 14:00 (CET)


Although pancreatic ductal adenocarcinoma (PDAC) is not so frequent, it is the third leading cause of cancer death. As it shows non-specific symptoms it is diagnosed late and only 20% of patients are surgery candidates. Tumor recurrs locally or distantly after surgery in two thirds of them. Only 5% of PDAC patients survive 10 years. Targeted therapies have not yet proven their efficacy and treatment prescribed consists of chemotherapy combinations.

PDAC has a dense stroma that reaches an 80% of the tumor, helping PDAC epithelial tumor cells to evade the immune system and growth, invade and metastasize through a crosstalk among PDAC cells and fibroblasts, macrophages, pericytes, stroma, etc. Targeting the stromal constituents may result in a step forward a better treatment efficacy.

PDAC microbiome is unique and has been identified into the cancer cells and the local immune cells. Wisely management of the different resident microbial species could also result in prevention and another alternative for treatment.

The identification of the PDAC high-risk population and the development of a convenient screening program is an objective to be reached for an earlier diagnosis and a potential advantage as more patients will be candidates for surgery, but to know in depth and detail the biology of the tumor and its interaction with the host will lead to a better treatment design and a real benefit of our patients.