Commentary - Archives of General Internal Medicine (2021) Volume 5, Issue 7
Prognostic medicine for hereditary pancreatic cancer.
Department of Internal Medicine, Division of Oncology, University of Utah School of Medicine, Salt Lake City, USA
- Corresponding Author:
- Conanain Kinselyi
Department of Internal Medicine
University of Utah School of Medicine
Salt Lake City
Email: Conanain Kinsely@hci.utah.edu
Accepted date:August 27, 2021
Citation: Kinsely C. Prognostic medicine for hereditary pancreatic cancer. Arch Gen Intern Med 2021;5(7):12.
Pancreatic cancer is the fourth main cause of cancer death in both men and women. However, it has the poorest prognosis of any key tumor type, with a 5-yr survival rate of roughly 5%. Cigarette smoking, enlarged body mass index, heavy alcohol use, and a diagnosis of diabetes mellitus have all been exhibited to raise risk of pancreatic cancer. A family history of pancreatic cancer has also been associated with rised risk advising inherited genetic factors also play a vital role, with roughly 5–10% of pancreatic cancer patients reporting family history of pancreatic cancer. Whereas the genetic basis for the most of the familial grouping of pancreatic cancer still unclear, so many vital pancreatic cancer genes have been recognised. These consist of high penetrance genes including BRCA2 or PALB2, to more common genetic modification associated with a modest rise risk of pancreatic cancer such as genetic variation at the ABO blood group locus. Recent progress in genotyping and genetic sequencing have stimulated the rate at which novel pancreatic cancer susceptibility genes have been recognized with so many genes identified within the past few years. Neoadjuvant chemo (radio) therapy is progressively used in pancreatic cancer. Inherited predisposition to pancreatic cancer provides remarkably to its incidence and presents a chance for the growth of early detection strategies. The genetic basis of liability still unexplained in a high proportion of patients with familial PC (FPC). Pancreatic cancer mortality rates have been rising in high-income nations. Pancreatic cancer is a highly destructive and especially difficult to treat. As the vast majority of patients are identified at advanced stage of the disease, only a small population is curative by surgical resection. Although gemcitabine-based chemotherapy is usually offered as standard of care, most patients do not persist longer than 6 months. Thus, new therapeutic methodologies are needed. Pancreatic cancer cells that progress gemcitabine resistance would still be suitable targets for immunotherapy. Therefore, one promising treatment method may be immunotherapy that is intended to target pancreatic-cancer-associated antigens. Immunotherapy is a rapidly growing field and denotes a paradigm shift in the treatment of malignancies as it offers a new therapeutic approach beyond surgery, conventional chemotherapy, and radiation treatment. Modern studies of human pancreatic cancers have shown a population of pancreatic cancer stem cells that have abnormally activated developmental signaling pathways, are resistant to standard chemotherapy and radiation, and have up-regulated signaling cascades that are essential for tumor metastasis. An upgraded understanding of the biological behavior of these cells may lead to more effective therapies to treat pancreatic cancer. Most patients present with advanced lesions at the time of diagnosis, and only 20% of patients are eligible for surgery. Consequently, drug treatment has become exceedingly important. At present, the main treatment procedures for pancreatic cancer are gemcitabine and the FORFIRINOX and MPACT programs. However, none of these programs significantly improves the prognosis of patients with pancreatic cancer. Substantial efforts have been dedicated to the study of pancreatic cancer in recent years. With the development and clinical application of biological targeted drugs, the biological targeted treatment of tumors has been extensively accepted.