Pancreatic Disorders & Therapy
Open Access

Advancements in Pancreatic Therapy: Challenges and Innovative Approaches

Okafor Chijioke^{* *}Correspondence: Okafor Chijioke, Department of Medical Oncology, University of Nigeria, Enugu State, Nigeria, Email:

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Description

Pancreatic cancer, particularly Pancreatic Ductal Adenocarcinoma (PDAC), remains one of the most challenging cancers to treat, with an alarmingly low survival rate. Despite significant advances in cancer therapy over the past few decades, PDAC continues to be associated with a grim prognosis, primarily due to its aggressive nature, late-stage diagnosis, and resistance to conventional treatments. The tumour microenvironment, characterized by dense fibrosis, immune suppression, and limited drug delivery, adds further complexity to treatment strategies. However, researchers and clinicians are continuously exploring innovative therapeutic approaches aimed at improving outcomes for patients suffering from this deadly disease.

Traditional therapies

Pancreatic cancer, including surgery, chemotherapy and radiotherapy, have significant limitations:

Surgery is the only curative option but is only feasible for early-stage tumors, and most patients are diagnosed at advanced stages, making it ineffective [1]. Chemotherapy, using drugs like gemcitabine and FOLFIRINOX, remains the standard but offers limited benefits and significant side effects due to drug resistance, poor blood flow, and a dense tumor stroma. Radiotherapy is used for palliation but is often ineffective due to challenges in delivering adequate doses, given the pancreas' location and surrounding critical structures.

Innovative approaches in pancreatic therapy

The complexities of pancreatic cancer have driven the development of novel therapies to directly target tumors, enhance existing treatments, and improve outcomes. Requiring advancements include targeted therapies, immunotherapy, nanomedicine, and stromal modulation [2].

Targeted therapies: Targeted therapies aim to block specific molecules or pathways that drive cancer growth. In pancreatic cancer, one key focus is KRAS mutation inhibition, as most pancreatic tumors harbor KRAS mutations that promote tumor initiation and progression [3-5]. Drugs like AMG 510 (sotorasib), which target KRAS, have shown potential in clinical trials by potentially reducing tumor growth. Another approach involves targeting the DNA damage response, particularly in tumors with BRCA1 and BRCA2 mutations, which make cancer cells more reliant on DNA repair. PARP inhibitors like olaparib are being tested in these patients, showing potential for improving outcomes by blocking this repair mechanism [6].

Immunotherapy: Immunotherapy, which uses the body’s immune system to fight cancer, has revolutionized the treatment of many cancers, but its application in pancreatic cancer has been more limited. One of the major challenges is the immunosuppressive tumor microenvironment of pancreatic cancer, which includes T-regulatory cells, Myeloid-Derived Suppressor Cells (MDSCs), and Cancer-Associated Fibroblasts (CAFs), all of which inhibit immune responses [7-9].

Nanomedicine: Nanotechnology offers requiring advancements in drug delivery for pancreatic cancer. The dense stromal tissue of tumors hinders drug penetration, but nanoparticles can be engineered to overcome this barrier. Nanoparticle-based drug delivery, such as liposomes or polymeric micelles, can encapsulate chemotherapy agents and release them directly within the tumor, enhancing drug efficacy while reducing toxicity. Theranostic nanoparticles, which both treat and diagnose cancer, are particularly exciting. These nanoparticles target tumor cells, deliver drugs, and provide real-time imaging to monitor treatment effectiveness [10].

Conclusion

The fight against pancreatic cancer remains difficult, but ongoing research into innovative therapeutic strategies offers hope. While traditional treatments have not significantly improved survival, targeted therapies, immunotherapy, nanomedicine, and stromal modulation are paving the way for more effective treatments. With continued progress, these innovative therapies have the potential to revolutionize the way we treat pancreatic cancer and, ultimately, improve the prognosis for patients battling this devastating disease.

References

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