This review highlights current treatments, limitations, and pitfalls in the management of pancreatic cancer and discusses current research in novel targets and drug development to overcome these clinical challenges. We begin with a review of the clinical landscape of pancreatic cancer, including genetic and environmental risk factors, as well as limitations in disease diagnosis and prevention. We next discuss current treatment paradigms for pancreatic cancer and the shortcomings of targeted therapy in this disease. Targeting major driver mutations in pancreatic cancer, such as dysregulation in the KRAS and TGFβ signaling pathways, have failed to improve survival outcomes compared with nontargeted chemotherapy; thus, we describe new advances in therapy such as Ras-binding pocket inhibitors. We then review next-generation approaches in nanomedicine and drug delivery, focusing on preclinical advancements in novel optical probes, antibodies, small-molecule agents, and nucleic acids to improve surgical outcomes in resectable disease, augment current therapies, expand druggable targets, and minimize morbidity. We conclude by summarizing progress in current research, identifying areas for future exploration in drug development and nanotechnology, and discussing future prospects for management of this disease.

中文翻译：

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胰腺腺癌：治疗非常规疾病的非常规方法。


这篇综述重点介绍了胰腺癌治疗的当前治疗方法、局限性和陷阱，并讨论了克服这些临床挑战的新靶点和药物开发的当前研究。我们首先回顾胰腺癌的临床情况，包括遗传和环境危险因素，以及疾病诊断和预防的局限性。接下来我们讨论当前胰腺癌的治疗范例以及该疾病靶向治疗的缺点。与非靶向化疗相比，针对胰腺癌的主要驱动突变，例如 KRAS 和 TGFβ 信号通路的失调，未能改善生存结果；因此，我们描述了 Ras 结合袋抑制剂等治疗的新进展。然后，我们回顾纳米医学和药物输送的下一代方法，重点关注新型光学探针、抗体、小分子药物和核酸的临床前进展，以改善可切除疾病的手术结果，增强现有疗法，扩大可药物靶点，并最大限度地减少发病率。最后，我们总结了当前研究的进展，确定了药物开发和纳米技术未来探索的领域，并讨论了该疾病管理的未来前景。