Pancreatic Cancer

The São Paulo International Consensus on Minimally Invasive Pancreatic Surgery for Cancer.

HPB : the official journal of the International Hepato Pancreato Biliary Association · 2026 · PMID 41419350

BACKGROUND: Although minimally invasive surgery is widely accepted across surgical disciplines, its role in pancreatic cancer continues to be debated. The objective of the São Paulo Consensus on Minimally Invasive Pancreatic Surgery (MIPS) was to establish consensus statements on the use of MIPS for pancreatic cancer, integrating contemporary evidence and recent advances. METHODS: A scoping literature review informed statement development across five thematic groups: (1) Left Pancreatectomy for Pancreatic Cancer, (…

Position statement on the pathological assessment of pancreatic resection specimens in pancreatic ductal adenocarcinoma by the Societat Catalana de Pàncrees and the Societat Catalana d'Anatomia Patològica.

Gastroenterologia y hepatologia · 2026 · PMID 41655901

BACKGROUND: The lack of standardised protocols for the pathological assessment of pancreatic resection specimens in pancreatic ductal adenocarcinoma results in substantial variability in diagnostic practice, with relevant clinical and organisational implications. OBJECTIVE: To present a position statement of the Societat Catalana de Pàncrees (SCPanc) and the Societat Catalana d'Anatomia Patològica (SCAP) on the pathological assessment of pancreatic resection specimens in exocrine pancreatic cancer. METHODS: Both sc…

NCCN Guidelines® Insights: Genetic/Familial High-Risk Assessment: Breast, Ovarian, Pancreatic, and Prostate, Version 2.2026.

Journal of the National Comprehensive Cancer Network : JNCCN · 2026 · PMID 41671423

The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Genetic/Familial High-Risk Assessment: Breast, Ovarian, Pancreatic, and Prostate are intended to serve as a resource for health care providers to identify individuals who may benefit from cancer risk assessment and genetic counseling and testing; help guide decisions related to genetic testing; and facilitate a multidisciplinary approach in the comprehensive care of individuals at increased risk for hereditary breast, ovarian, pancreatic, and p…

Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with pancreatic cancer.

ESMO open · 2025 · PMID 41067164

The European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with pancreatic cancer, published in November 2023, were adapted in December 2024, according to previously established standard methodology, to produce the Pan-Asian adapted (PAGA) ESMO consensus guidelines for the management of Asian patients with pancreatic cancer. The adapted guidelines presented in this manuscript represent the consensus opinions reached by a panel of Asian expert…

ACR Appropriateness Criteria® Screening, Locoregional Assessment, and Surveillance of Pancreatic Ductal Adenocarcinoma: 2025 Update.

Journal of the American College of Radiology : JACR · 2025 · PMID 41193048

Pancreatic ductal adenocarcinoma is a highly lethal cancer that often presents with vague and indolent symptoms leading to advanced stage diagnosis. Imaging plays a crucial role in the diagnosis, assessment of locoregional and metastatic disease, surgical planning, and surveillance after neoadjuvant therapy and surgery. This document reviews available imaging modalities that are best used for these clinical scenarios, and a summary of current evidence is provided to support the use of the various modalities in each…

Symptom Management for Well-Differentiated Gastroenteropancreatic Neuroendocrine Tumors: ASCO Guideline.

JCO oncology practice · 2026 · PMID 40344544

PURPOSE: To develop a clinical practice guideline and recommendations for symptom management of patients with well-differentiated grade 1 to grade 3 metastatic gastroenteropancreatic neuroendocrine tumors. METHODS: ASCO convened an Expert Panel to develop a clinical practice guideline by reviewing the literature for relevant guidelines, systematic reviews, randomized controlled trials (RCTs), and observational studies to develop recommendations for clinical practice. RESULTS: The literature review identified eight …

Clinical practice guidelines for the management of non-functioning advanced GEP-NENs: a GRADE approach for evidence evaluation and recommendations by the Italian Association of Medical Oncology (AIOM) in collaboration with the Italian Association for Neuroendocrine Tumors (ITANET).

ESMO open · 2025 · PMID 41223791

Neuroendocrine neoplasms (NENs) of the gastroenteropancreatic (GEP) tract represent a rare and heterogeneous group of malignancies. They are distinguished into well-differentiated and poorly differentiated neoplasms, with clinical behavior ranging from relatively indolent to fast-growing, respectively. Surgery is the curative option for localized disease, especially in well-differentiated neoplasms, while various systemic therapies are approved and clinically available for advanced disease. However, considering the…

Radiotherapy of pancreatic cancers: 2025 update.

Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique · 2025 · PMID 40839896

We present the updated recommendations of the French Society of Radiotherapy Oncology (Société française de radiothérapie oncologique, SFRO) on radiotherapy for pancreatic cancer. The place of radiation therapy in the treatment of patients with resectable or locally advanced pancreatic cancer is still controversial. In the postoperative setting, the standard treatment is adjuvant chemotherapy with 5-fluorouracil, irinotecan and oxaliplatin ("folfirinox" regimen) for 6 months. Adjuvant chemoradiotherapy may be benef…

pRECIST: Guidelines for Response Criteria for Use in Trials Testing Therapeutics in Pancreatic Cancer.

Pancreas · 2026 · PMID 41941588

IMPORTANCE: Pancreatic tumor response to treatment remains challenging and varies greatly. In order to establish a standardized approach to measuring and evaluating pancreatic tumor metabolic activity (MA), a consensus guideline called Pancreatic RECIST (pRECIST) was developed. This guideline is based on modified Response Evaluation Criteria in Solid Tumors (RECIST version 1.1), incorporating concurrent CT/PET scan quantitative assessments. OBJECTIVE: The aims were to ensure consistent design, data collection, and …

ACR Appropriateness Criteria® Staging and Follow-Up of Pancreatic Neuroendocrine Tumors.

Journal of the American College of Radiology : JACR · 2026 · PMID 41823937

Accurate staging and appropriate follow-up imaging of pancreatic neuroendocrine tumors (PNET) are essential for guiding management and optimizing outcomes. This document provides evidence-based recommendations for the imaging evaluation of patients with PNET across six clinical variants: local staging, staging for metastatic disease, surveillance postresection, follow-up after treatment of liver-dominant and non-liver dominant disease, and follow-up of untreated disease. Contrast-enhanced CT is usually appropriate …

Clinical Practice Guidelines for Pancreatic Cancer 2025 From the Japan Pancreas Society: A Synopsis.

Pancreas · 2026 · PMID 41342569

OBJECTIVES: The Clinical Practice Guidelines for Pancreatic Cancer were first published in 2006 by the Japan Pancreas Society and have been revised in 2009, 2013, 2016, 2019, and 2022. In July 2025, a newly revised version was released in Japanese. METHODS: This latest revision was developed in accordance with the Minds Manual for Guideline Development 2020, which incorporates the principles of GRADE (Grading of Recommendations Assessment, Development, and Evaluation) to improve clarity, transparency, and reliabili…

When is surgery futile? A systematic review of conflicting definitions and patterns in surgical care for advanced gastrointestinal cancer.

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2025 · PMID 40857984

OBJECTIVE: To report current definitions of futility and futility rates for patients undergoing advanced gastrointestinal (GI) cancer surgery. BACKGROUND: Surgery remains the primary treatment option for selected patients with advanced GI cancer, demonstrating significant survival benefits when successful. However, surgeries that fall short of expectations may be viewed as 'futile'. Despite the clinical and ethical importance of futility, no universally accepted definition of futility exists in this cohort. METHODS…

Recommendations on the surveillance and supplementation of vitamins and minerals for upper gastrointestinal cancer survivors: a scoping review.

Journal of cancer survivorship : research and practice · 2026 · PMID 39207682

BACKGROUND: Early-stage upper gastrointestinal (UGI) cancer patients, after surgery, have altered gastrointestinal functions, compromising their nutritional status and health outcomes. Nutritional care provision to UGI survivors rarely focuses on long-term survivorship. Here, we explore recommendations for surveillance of micronutrient deficiency and supplementation for UGI cancer survivors after surgery. METHODS: A scoping review, based on the Joanna Briggs Institute methodology for scoping reviews. Six databases …

Nutritional Therapy in Pancreatic Cancer: Mechanisms, Clinical Applications, and Future Perspectives.

Nutrition and cancer · 2026 · PMID 42411702

BACKGROUND: Pancreatic cancer is frequently complicated by malnutrition, cancer cachexia, pancreatic exocrine insufficiency (PEI), and sarcopenia, all of which adversely affect treatment tolerance, quality of life, and survival. OBJECTIVE: To review the pathophysiology, assessment, and contemporary nutritional management of pancreatic cancer, with a focus on cachexia, PEI, body composition, and personalized nutritional care. METHODS: This narrative review summarizes evidence from clinical guidelines, randomized tri…

Futility in adenosquamous pancreatic cancer.

World journal of surgical oncology · 2026 · PMID 42157261

BACKGROUND: Adenosquamous carcinoma of the pancreas (ASCP) is a rare and aggressive subtype of pancreatic cancer with a dismal prognosis. Futility in ASCP has been inadequately studied. The aim is to assess the incidence of futility in ASCP cases within a European cohort. METHODS: Retrospective, multicenter European study including all consecutive patients who underwent surgery for ASCP between 2010 and 2024. INCLUSION CRITERIA: patients operated for ASCP during the study period. EXCLUSION CRITERIA: patients withou…

Combined Impact of Neoadjuvant Therapy and Preoperative Cachexia in Patients Undergoing Pancreatoduodenectomy: Is There a "Double Jeopardy"? A National Cohort Study Investigating the Association with Short- and Long-Term Outcomes.

Annals of surgical oncology · 2026 · PMID 41486235

BACKGROUND: Cachexia is associated with worse postoperative outcomes, but the added role of neoadjuvant therapy (NAT) is unclear. This study evaluated whether preoperative cachexia and NAT act as a "double jeopardy" after pancreatoduodenectomy. PATIENTS AND METHODS: A nationwide observational cohort study was conducted using the Norwegian NORGAST registry (2016-2023). Adults undergoing pancreatoduodenectomy for malignancy were included. Cachexia was defined by consensus weight-loss criteria. Modified Poisson and Co…

Reproducibility and Consistency of Methods to Define Hospital-Level Procedural Volume Thresholds for Pancreatectomy.

Journal of surgical oncology · 2026 · PMID 41241876

INTRODUCTION: Procedural volume thresholds (VTs) for hospital quality reporting rely on expert consensus or analytic methods that may produce inconsistent VTs (e.g. restricted cubic splines (RCS), optimal cutpoints, classification and regression trees (CART), stratum specific likelihood ratios (SSLR)). The objective of this study was to compare variation in hospital-level VTs for pancreatectomy across multiple methodologies. METHODS: Patients undergoing pancreatectomy from 2004 to 2021 were identified using the Nat…

EXTRA-PANCREATIC MANIFESTATION IN AUTOIMMUNE PANCREATITIS VERSUS CONVENTIONAL PANCREATITIS: AN EGYPTIAN COHORT.

Arquivos de gastroenterologia · 2025 · PMID 41172428

BACKGROUND: Autoimmune pancreatitis (AIP) is a specific form of pancreatitis that is characterized by obstructive jaundice and sometimes associated with pancreatic masses, lymphoplasmacytic infiltrate and fibrosis, with a marked response to steroids. According to International Consensus Diagnostic Criteria AIP is categorized into type 1, type 2, and not otherwise specified (NOS). AIP-1 is one of the presentations of the IgG4-related disease (IgG4-RD) characterized by lymphoplasmacytic infiltration and more than ten…

Evaluating Tumor Regression and Survival Outcomes in Pancreatic Ductal Adenocarcinoma After Neoadjuvant Treatment according to CAP Grading System: Clinical Usefulness and Limitations.

Annals of surgical oncology · 2025 · PMID 40858953

BACKGROUND: Neoadjuvant treatment (NAT) is increasingly employed for pancreatic ductal adenocarcinoma (PDAC), necessitating reliable methods to assess tumor response. The College of American Pathologists (CAP) grading system is widely used to predict chemo-responsiveness and survival, but consensus on the most effective grading system and treatment regimen remains elusive. PATIENTS AND METHODS: This retrospective study included 462 patients with PDAC who underwent resection after NAT between 2009 and 2023. Survival…

Association of Tumor Budding Grade With Immunohistochemical Expression of Thrombin and PAR-1 in Pancreatic Ductal Adenocarcinoma.

Anticancer research · 2025 · PMID 41151881

BACKGROUND/AIM: The coagulation system affects the early (initiation, angiogenesis), middle (growth, invasion) and late stages (metastasis, relapse) of cancer progression. Tumor budding is a histomorphological marker of aggressive tumor behavior. The aim of this paper was to explore the relationship of thrombin, PAR-1 and tumor budding (TB) in pancreatic ductal adenocarcinoma (PDAC). PATIENTS AND METHODS: Patients who underwent surgery for PDAC (n=46) were included in the study. Socio-demographic and clinicopatholo…

Postoperative recurrence patterns and anatomy-stratified clinical target volume delineation in pancreatic cancer.

Radiation oncology (London, England) · 2026 · PMID 41520105

OBJECTIVES: This study aims to characterize postoperative recurrence patterns and anatomical distribution in patients with pancreatic cancer within the framework of extrapancreatic neural tract anatomy. Based on the observed recurrence sites, we propose stratified clinical target volume (CTV) delineation recommendations for postoperative adjuvant radiotherapy. METHODS: We retrospectively analysed 352 patients who underwent resection for pancreatic adenocarcinoma and recorded the sites of initial postoperative recur…

Molecular Subtype Identification and Prognostic Prediction of Pancreatic Cancer Based on m6A/m5C/m1A-Related Genes.

Journal of cellular and molecular medicine · 2026 · PMID 42366608

Pancreatic cancer, characterized by an unfavourable prognosis, necessitates early diagnosis and prompt therapeutic intervention. This study aimed to delineate the functional implications of m6A/m1A/m5C-related genes in pancreatic carcinogenesis and establish a prognostic model. Utilizing data from the TCGA-PAAD cohort (n=178) combined with GTEx normal pancreatic tissues (n=332), we identified 43 genes associated with m6A/m1A/m5C methylation pathways. Significant expression differences in these genes were observed b…

Tumor Budding and E-Cadherin Loss as Robust Prognostic Markers in Pancreatic Ductal Adenocarcinoma: A Study in a Turkish Patient Cohort.

Canadian journal of gastroenterology & hepatology · 2025 · PMID 41245223

OBJECTIVE: This study investigates the prognostic significance of tumor budding and its association with E-cadherin expression in pancreatic ductal adenocarcinoma (PDAC) with a focus on a Turkish patient cohort. METHODS: A total of 76 patients who had undergone resection of PDAC were analyzed. Tumor budding was assessed according to Tumor Budding Consensus Conference (ITBCC) guideline and classified as low (1-4 buds), medium (5-9 buds), or high (≥ 10 buds). E-cadherin expression was assessed by immunohistochemistry…

Testing remote feedback using a virtual semi-automated educational tool for the detection of pancreatic tumour-vessel contact on staging CT.

Current problems in diagnostic radiology · 2026 · PMID 41162206

PURPOSE: Assessing tumour-vessel contact in pancreatic adenocarcinoma on CT is challenging for trainees and time-intensive for educators. Semi-automating feedback on this task may optimize radiologist time and standardize resident education. We hypothesized that residents who reviewed expert annotations of tumour-vessel contact would outperform those without feedback on an independent test set. METHODS: We retrospectively reviewed pre-operative staging CTs from 60 patients who underwent upfront surgical resection f…

68Ga-DOTATATE PET/CT versus MRI in neuroendocrine liver metastases: a comprehensive per-lesion analysis.

La Radiologia medica · 2025 · PMID 40932677

PURPOSE: To evaluate the diagnostic performance of 68Ga-DOTATATE PET, contrast-enhanced CT, combined DOTATATE PET/CT, and MRI in detecting neuroendocrine liver metastases on a per-lesion basis and to assess the added value of diagnostic contrast-enhanced CT to PET interpretation as well as influence of lesion size. MATERIALS AND METHODS: This retrospective study evaluated patients with histologically-confirmed gastroenteropancreatic neuroendocrine tumors who underwent both contrast-enhanced MRI and 68Ga-DOTATATE PE…

Systematic Review and Pooled Analysis of 1,021 Children With Pancreatic Tumors.

The Journal of surgical research · 2026 · PMID 42335633

INTRODUCTION: Although relatively rare, pediatric pancreatic tumors have been increasingly reported in the literature. Our aim was to systematically review the literature on the clinical characteristics, management, and outcomes of pediatric pancreatic tumors. METHODS: We performed a systematic review of the MEDLINE, Scopus, Web of Science, and Cochrane Library databases (end-of-search date: June 2022) according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. RESULTS: Sixty-four…

Adult Chronic Pancreatitis Working Group: Goals, Accomplishments and the Path Ahead. A Report From the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer.

Pancreas · 2026 · PMID 42348838

The adult chronic pancreatitis (CP) working group, formed at the inception of the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (CPDPC), has developed a robust framework and infrastructure to conduct clinical, translational, and mechanistic studies of CP. At its core is PRO spective Evaluation of C hronic Pancreatitis for E pid E miologic and Translational Stu D ies (PROCEED), the first longitudinal cohort study of CP in US adults, launched in 2017. PROCEED has developed a well-a…

Nutritional Therapy in Pancreatic Cancer: Mechanisms, Clinical Applications, and Future Perspectives.

Nutrition and cancer · 2026 · PMID 42411702

BACKGROUND: Pancreatic cancer is frequently complicated by malnutrition, cancer cachexia, pancreatic exocrine insufficiency (PEI), and sarcopenia, all of which adversely affect treatment tolerance, quality of life, and survival. OBJECTIVE: To review the pathophysiology, assessment, and contemporary nutritional management of pancreatic cancer, with a focus on cachexia, PEI, body composition, and personalized nutritional care. METHODS: This narrative review summarizes evidence from clinical guidelines, randomized tri…

Tumor Microenvironment Gene Engineering with LOAd703 in Patients with Solid Malignancies: LOKON002 Phase I/IIb Clinical Trial.

Clinical cancer research : an official journal of the American Association for Cancer Research · 2026 · PMID 42053989

PURPOSE: Patients with advanced cancer have a poor prognosis and need for novel treatments. LOAd703 is a tumor microenvironment (TME) gene engineering viral vector encoding genes targeting the CD40 and 4-1BB pathways. In this study, tolerability (primary endpoint), response activity, and the capacity to inflame the TME were evaluated. PATIENTS AND METHODS: In an open-label, single-arm phase I/IIb clinical trial (NCT03225989), a maximum of eight intratumoral injections of LOAd703 were administered biweekly, combined…

Semiannual surveillance facilitates detection of surgically treatable intraductal papillary mucinous neoplasm-derived and concomitant carcinoma: a multicenter prospective observational study.

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · 2026 · PMID 42399187

BACKGROUND: Intraductal papillary mucinous neoplasm (IPMN) is a well-recognized precursor of pancreatic cancer; however, the optimal surveillance strategy for IPMN remains controversial. This study aimed to evaluate the clinical impact of semiannual surveillance using endoscopic ultrasonography (EUS) and magnetic resonance imaging (MRI) for the detection of malignant transformation, including IPMN-derived and concomitant carcinoma. METHODS: This multicenter prospective observational study included 360 patients with…

REG4 serves as a prognostic biomarker for pancreatic cancer with long-standing diabetes mellitus by modulating chemoresistance.

Translational oncology · 2026 · PMID 42398462

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) in patients with diabetes mellitus (DM) represents a clinically heterogeneous subgroup, yet biomarkers that reflect diabetes-associated tumor biology and chemotherapy response remain limited. In particular, the influence of diabetes duration on treatment resistance in PDAC is poorly understood. METHODS: We performed an integrated translational analysis combining reanalysis of public single-cell RNA sequencing (scRNA-seq) datasets, clinical serum biomarker profilin…

Mainstream and fast-track genetic testing in pancreatic cancer patients and its impact on treatment: our experience in a tertiary hospital in Spain.

Familial cancer · 2026 · PMID 42541517

Pancreatic cancer (PC) is a highly lethal malignancy. 4-10% are linked to inherited mutations in genes such as BRCA1/2, PALB2, ATM and mismatch repair (MMR) genes. Germline testing is essential to guide treatment decisions, yet delays remain common. Genetic testing models without pre-test assessment in a Hereditary Cancer Unit (HCU), have emerged as a strategy to improve earlier clinical decision-making. A retrospective, observational and descriptive study was conducted on 223 PC patients (55% male; average age 64 …

Risk-stratified surveillance for individuals in the UK at high risk of developing pancreatic cancer: Outcomes from the European Registry of Hereditary Pancreatic Diseases (EUROPAC).

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 41740463

BACKGROUND: Surveillance of individuals with a familial predisposition to pancreatic ductal adenocarcinoma (PDAC) is likely to increase overall survival. Our objective was to determine the impact of EUROPAC risk-stratification (Family Risk, FR), in such predisposed individuals. METHODS: Observational study of registered asymptomatic individuals undergoing surveillance for PDAC. Individuals without a known pathogenic variant (PV-), ineligible for genetic assessment in the NHS, in whom significant pancreatic lesions …

Pancreatic findings in participants in a program of low-dose computed tomography screening for lung cancer.

European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) · 2026 · PMID 41247705

PURPOSE: This study investigates the frequency, progression, and clinical implications of pancreatic findings on chest low-dose computed tomography (LDCT) scans performed for lung cancer screening. METHODS: Analyzing data from the I-ELCAP cohort study (February 2010-June 2023), we identified participants with pancreatic findings on LDCT scans, recording demographics and outcomes. Radiologists reviewed baseline and latest LDCT scans. RESULTS: Out of 9467 participants, 90 (0.9%) had pancreatic findings, mostly male (…

€2.7 billion for the treatment of patients with pancreatic cancer: an overview and perspectives in France.

Clinics and research in hepatology and gastroenterology · 2026 · PMID 42349678

INTRODUCTION: Pancreatic cancer is an aggressive disease that is typically diagnosed at an advanced stage. The five-year overall survival rate is below 10%. Despite the increasing incidence of pancreatic cancer, data on the economic burden of the disease in France are scarce. The objective of the present study was to estimate the economic burden of pancreatic cancer from the perspective of the French health insurance system. METHODS: A cohort of patients diagnosed in 2014 was identified using data from the French N…

Differentiation of intraductal papillary mucinous neoplasms and pancreatic ductal adenocarcinoma using arterial-phase CT radiomics combined with clinical features.

Frontiers in oncology · 2026 · PMID 42539463

OBJECTIVE: To investigate the value of arterial-phase CT-based radiomics combined with clinical features in differentiating IPMN (Intraductal Papillary Mucinous Neoplasms) from PDAC (Pancreatic Ductal Adenocarcinoma). METHODS: A total of 216 patients with pathologically confirmed IPMN or PDAC were retrospectively enrolled. Clinical data and contrast-enhanced CT images were collected. Patients were divided into a training cohort, a test cohort and the external validation cohort. Univariate and multivariate analyses …

Prognostic Value of Digitally Quantified CDX2 Expression in Pancreatic Ductal Adenocarcinoma Without Intestinal Differentiation.

International journal of surgical pathology · 2026 · PMID 41944427

BackgroundCDX2 is a transcription factor critical for intestinal development and differentiation. While its prognostic value is established in colorectal cancer, its significance in pancreatic ductal adenocarcinoma (PDAC) remains unclear. Given the overlap of intestinal-type features in intraductal papillary mucinous neoplasms (IPMNs), clarifying the role of CDX2 in PDAC and IPMN may provide insights into tumor biology and prognostic markers.MethodsWe retrospectively analyzed 35 PDAC and 42 IPMN-associated carcinom…

Oil blotting paper for formalin fixation increases endoscopic ultrasound-guided tissue acquisition-collected sample volumes on glass slides.

Cancer medicine · 2024 · PMID 38706442

OBJECTIVES: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is used for pathological diagnosis and obtaining samples for molecular testing, facilitating the initiation of targeted therapies in patients with pancreatic cancer. However, samples obtained via EUS-TA are often insufficient, requiring more efforts to improve sampling adequacy for molecular testing. Therefore, this study investigated the use of oil blotting paper for formalin fixation of samples obtained via EUS-TA. METHODS: This prospective stud…

Expression of the Galanin system in the human pancreas, pancreatitis, and pancreatic cancer: Association with nodal involvement and perineural invasion.

Neuropeptides · 2026 · PMID 42302555

Pancreatic ductal adenocarcinoma (PDAC) remains one of the deadliest malignancies, with a five-year survival rate of 6%, yet the underlying causes remain poorly understood. The neuropeptide galanin (GAL) and its three receptors (GAL1-3-R) are known to modulate tumor biology. This study characterizes the expression patterns of the GAL system in healthy and diseased pancreas to evaluate its potential as a biomarker for disease progression. Immunohistochemical staining for GAL and GAL1-3-R was performed on tissue samp…

The Mesopancreas remains at risk in primary resectable pancreatic cancer patients: time to reappraise resectability criteria?

Cancer treatment and research communications · 2026 · PMID 41861538

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is associated with poor survival, and complete surgical resection with a negative circumferential resection margin (R0CRM-) remains the only potentially curative treatment. Current resectability criteria primarily stratify patients according to arterial and portomesenteric venous involvement. However, the impact of mesopancreatic infiltration on resection margin status within these classifications remains unclear. METHODS: A consecutive cohort of 271 patients unde…

Synthetic lethality targets in pancreatic ductal adenocarcinoma: prevalence and limitations of liquid biopsy detection in a minority-serving cancer center.

Future oncology (London, England) · 2026 · PMID 42422981

AIMS: Synthetic lethality (SL) exploits genetic vulnerabilities in cancer cells, offering therapeutic opportunities beyond conventional targets. While BRCA/poly(ADP-ribose) polymerase (PARP) inhibition is FDA-approved for pancreatic ductal adenocarcinoma (PDAC), the prevalence of other actionable SL targets remains poorly characterized. PATIENTS AND METHODS: We retrospectively analyzed 260 PDAC patients at the University of New Mexico Comprehensive Cancer Center (2017-2022); 74 underwent somatic sequencing (54 tiss…

A deep learning pathomic signature predicts survival and recurrence in pancreatic ductal adenocarcinoma independent of CA19-9.

Cancer letters · 2026 · PMID 41887395

The stratification of pancreatic ductal adenocarcinoma (PDAC) remains challenging due to the limitations of current staging systems and the ineffectiveness of the serum biomarker CA19-9 in a significant patient subgroup. We developed and validated a deep learning-based pathomic signature (PCPSDL) using routinely acquired haematoxylin and eosin (H&E)-stained whole-slide images from 252 patients at our institution and an external cohort of 183 patients from TCGA. PCPSDL robustly predicted overall and recurrence-free …

The Global Immune-Nutrition-Inflammation Index Is Associated with Survival Outcomes and Enhances Prognostic Discrimination in Metastatic Pancreatic Cancer.

Medicina (Kaunas, Lithuania) · 2026 · PMID 42512821

Background and Objectives: Metastatic pancreatic ductal adenocarcinoma (PDAC) continues to carry a poor prognosis despite advances in treatment, underscoring the need for simple and accessible biomarkers that reflect tumor-host interactions. The Global Immune-Nutrition-Inflammation Index (GINI), which combines inflammatory, immune, and nutritional parameters, may offer improved prognostic stratification compared with conventional indices. Materials and Methods: This retrospective cohort study included 126 patients …

Dynamic Prognostic Nutritional Index With Circulating Tumor DNA Predicts Survival in Localized Pancreatic Ductal Adenocarcinoma.

Journal of surgical oncology · 2026 · PMID 42226668

BACKGROUND AND OBJECTIVES: To evaluate the prognostic significance of baseline and longitudinal changes in prognostic nutritional index (PNI) in localized pancreatic ductal adenocarcinoma (PDAC) and to assess the complementary prognostic value of PNI with tumor burden measured by circulating tumor DNA (ctDNA). METHODS: We analyzed 127 patients with localized PDAC enrolled in a prospective biomarker study (2020-2024). Laboratory values were collected at five standardized timepoints. PNI was calculated as (10 × album…

An integrated multi-omics biomarker approach using molecular profiling and microRNAs for evaluation of pancreatic cyst fluid.

Cancer cytopathology · 2025 · PMID 40106268

BACKGROUND: Classification and risk stratification of pancreatic cysts are challenging because of limited radiographic and cytomorphologic features. Although molecular profiling has emerged as an ancillary test for pancreatic cyst fluid (PCF), additional high-sensitivity and -specificity biomarkers are still needed for improved classification. METHODS: In this study, PCF from 93 patients, including intraductal papillary mucinous neoplasms (n = 65), mucinous cystic neoplasms (n = 9), serous cystadenomas (n = 9), pan…

Enhanced Molecular Staging of Pancreatic Cancer Using Methylated DNA Markers in Peritoneal Lavage Fluid.

Journal of surgical oncology · 2026 · PMID 42226556

BACKGROUND AND OBJECTIVES: Occult intra-abdominal metastases are identified in approximately 20% of patients with radiographically localized pancreatic ductal adenocarcinoma (PDAC) through staging laparoscopy, as peritoneal cytology is limited in sensitivity. Methylated DNA markers (MDMs) have demonstrated high diagnostic accuracy for PDAC in tumor tissue, blood, and pancreatic secretions. This study assesses the feasibility and diagnostic performance of MDMs in peritoneal lavage fluid collected during staging lapa…

The benefit of deep genomic testing for asymptomatic high-risk individuals undergoing surveillance for pancreatic adenocarcinoma: European registry for hereditary pancreatic diseases (EUROPAC-PLUS).

Neoplasia (New York, N.Y.) · 2026 · PMID 42361786

INTRODUCTION AND AIMS: Surveillance is recommended for High-Risk Individuals (HRI) who are predisposed to pancreatic ductal adenocarcinoma (PDAC), because of familial (i.e., genetic) predisposition. All individuals under consideration for such surveillance in the UK, are registered and risk scored by the European Registry for Hereditary Pancreatic Diseases (EUROPAC). We generated a family risk score (FR) to optimize pancreatic cancer surveillance, started using this in 2020 and have recently validated it. Our aim w…

Urine Cell-Free DNA in the Diagnosis of Intraductal Papillary Mucinous Neoplasms: A Prospective Observational Study.

Annals of surgical oncology · 2026 · PMID 42536239

BACKGROUND: Intraductal papillary mucinous neoplasm (IPMN) is a typical precursor lesion of pancreatic cancer, but differential diagnosis and grading of IPMN is often difficult. Currently, grading of diagnosis is based mainly on imaging examinations, but these methods are invasive, and the accuracy is unsatisfactory. Therefore, the current study aimed to determine the usefulness of urine cell-free DNA (cfDNA) as a liquid biopsy, which the authors suggest has potential as a less invasive diagnostic tool for IPMN. ME…

Unraveling the roles of DKK1 and S100P in pancreatic ductal adenocarcinoma: Insights from machine learning, single-cell/spatial transcriptomics, and functional validation.

Translational oncology · 2026 · PMID 42537428

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy with a 5-year survival rate of only 13%. Despite recent advances in diagnosis and treatment, the prognosis of PDAC remains poor, largely owing to its complex tumor microenvironment, epithelial heterogeneity, and therapeutic resistance. In this study, we integrated bulk transcriptomic datasets, single-cell RNA sequencing (scRNA-seq), spatial transcriptomics (ST), machine learning analysis, and functional validation to investigate candidate bio…

Intraductal Papillary Mucinous Neoplasm (IPMN) of the Pancreas: History, Myths, and Realities Between Past and Future.

Medical sciences (Basel, Switzerland) · 2026 · PMID 42506374

Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is among the most clinically relevant and conceptually intricate precancerous lesions encountered in modern gastroenterology. First identified in the early 1980s as a "mucin-producing tumor," IPMN has since undergone a profound redefinition: from an obscure and poorly classified entity to a well-established precursor of pancreatic ductal adenocarcinoma (PDAC), shaped by characteristic molecular alterations such as KRAS, GNAS, and RNF43 mutations. Over t…

pRECIST: Guidelines for Response Criteria for Use in Trials Testing Therapeutics in Pancreatic Cancer.

Pancreas · 2026 · PMID 41941588

IMPORTANCE: Pancreatic tumor response to treatment remains challenging and varies greatly. In order to establish a standardized approach to measuring and evaluating pancreatic tumor metabolic activity (MA), a consensus guideline called Pancreatic RECIST (pRECIST) was developed. This guideline is based on modified Response Evaluation Criteria in Solid Tumors (RECIST version 1.1), incorporating concurrent CT/PET scan quantitative assessments. OBJECTIVE: The aims were to ensure consistent design, data collection, and …

Association of dietary intake and serum levels of unsaturated fatty acids and risk of pancreatic cancer: A GRADE-assessed systematic review and dose-response meta-analysis of prospective cohort studies.

Cancer epidemiology · 2026 · PMID 42235418

Lifestyle and dietary factors contribute to about one-third of cancer deaths. The fatty acid composition in diets may be related to pancreatic cancer. A prior meta-analysis examining the connection between mono- and polyunsaturated fatty acid intake and pancreatic cancer risk has not investigated the dose-response relationship. This systematic review and dose-response meta-analysis aims to explore the association between dietary intake and serum levels of unsaturated fatty acids and the risk of pancreatic cancer in…

Early onset pancreatic Cancer: epidemiology, molecular features, and clinical outcomes.

Cancer treatment reviews · 2026 · PMID 42341370

Background Early onset pancreatic cancer (EOPC), defined for the primary analysis as pancreatic ductal adenocarcinoma (PDAC) diagnosed before the age of 50 years, is an increasingly recognised clinical and epidemiological entity. Because published studies use heterogeneous age thresholds, the present review prespecified <50 years as the main definition and interpreted studies using other cutoffs in sensitivity or narrative analyses. Methods We systematically searched PubMed, EMBASE, and the Cochrane Library for stu…

ACR Appropriateness Criteria® Staging and Follow-Up of Pancreatic Neuroendocrine Tumors.

Journal of the American College of Radiology : JACR · 2026 · PMID 41823937

Accurate staging and appropriate follow-up imaging of pancreatic neuroendocrine tumors (PNET) are essential for guiding management and optimizing outcomes. This document provides evidence-based recommendations for the imaging evaluation of patients with PNET across six clinical variants: local staging, staging for metastatic disease, surveillance postresection, follow-up after treatment of liver-dominant and non-liver dominant disease, and follow-up of untreated disease. Contrast-enhanced CT is usually appropriate …

Position statement on the pathological assessment of pancreatic resection specimens in pancreatic ductal adenocarcinoma by the Societat Catalana de Pàncrees and the Societat Catalana d'Anatomia Patològica.

Gastroenterologia y hepatologia · 2026 · PMID 41655901

BACKGROUND: The lack of standardised protocols for the pathological assessment of pancreatic resection specimens in pancreatic ductal adenocarcinoma results in substantial variability in diagnostic practice, with relevant clinical and organisational implications. OBJECTIVE: To present a position statement of the Societat Catalana de Pàncrees (SCPanc) and the Societat Catalana d'Anatomia Patològica (SCAP) on the pathological assessment of pancreatic resection specimens in exocrine pancreatic cancer. METHODS: Both sc…

One out of four patients with pancreatic cancer experience psychological symptoms: A systematic review and meta-analysis.

PloS one · 2026 · PMID 42201880

The death rate from pancreatic cancer is one of the highest of all cancers, with increasing incidence every year over the past decades. As the prognosis remains extremely poor, this trend brings not only a growing clinical challenge, but also a significant psychological toll for patients. In comparison to other types of cancer, our understanding of the psychological burden of such a deadly disease is still limited. Recognizing and addressing the psychological aspects of pancreatic cancer are crucial for comprehensi…

Association of multidisciplinary team management with clinical outcomes in hepatobiliary and pancreatic malignancies: A systematic review and meta-analysis.

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2026 · PMID 42314305

BACKGROUND: Multidisciplinary team (MDT) management is widely endorsed for complex hepatobiliary and pancreatic (HBP) malignancies. However, robust systematic evidence evaluating its survival benefits and heterogeneity across distinct anatomical sites remains limited. METHODS: Our study systematically searched four databases from their inception through Dec 17, 2025, for studies comparing MDT versus non-MDT care in HBP malignancies. The primary outcome was overall survival or mortality risk. Secondary outcomes incl…

Prognostic value of tumor-infiltrating lymphocytes and common subtypes in patients with gastroenteropancreatic neuroendocrine neoplasms: a systematic review and meta-analysis.

BMC cancer · 2026 · PMID 42071196

BACKGROUND: The incidence of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) has been rising. However, current prognostic evaluation systems have certain limitations. As a key component of the tumor microenvironment, the prognostic value of tumor-infiltrating lymphocytes (TILs) in GEP-NENs remains controversial. This study aims to systematically evaluate the prognostic impact of common TILs subsets, including CD3+, CD4+, CD8+, and FoxP3 + cells, in patients with GEP-NENs to provide evidence-based support…

Quantifying Weight Loss Prior to Pancreatic Cancer Diagnosis: A Systematic Review and Meta-Analysis.

Cancer medicine · 2026 · PMID 42219540

INTRODUCTION: Pancreatic cancer has a high mortality rate due to late diagnosis and presentation with non-specific symptoms like weight loss. Quantifying weight loss more precisely could enhance its utility as a diagnostic marker. METHODS: In March 2025, we systematically searched PubMed, Embase, Web of Science, The Cochrane Library, and Scopus for studies reporting quantitative pre-diagnosis weight loss in pancreatic cancer, with no date restrictions. The protocol was registered with PROSPERO (CRD42022302985). Pri…

Robot-assisted versus laparoscopic distal pancreatectomy: an updated systematic review and meta-analysis including patient subgroups and meta-regression analyses.

Journal of robotic surgery · 2026 · PMID 42133237

Robot-assisted distal pancreatectomy (RDP) was developed to overcome technical limitations of laparoscopic distal pancreatectomy (LDP), yet uncertainty persists regarding oncologic adequacy, learning-curve effects, and outcomes in high-risk subgroups. We synthesized current evidence to address these gaps. We systematically searched PubMed and EMBASE, in accordance with PRISMA guidelines, from inception to 2025 to identify comparative studies of RDP versus LDP. Using random-effects models, we calculated weighted mea…

Impact of postoperative pancreatic fistula (POPF) on long-term outcomes of patients who underwent pancreatic cancer resection: systematic review and meta-analysis.

Surgical oncology · 2026 · PMID 42242032

INTRODUCTION: Postoperative pancreatic fistula (POPF) is a major complication resulting from pancreatic resection. The long-term oncological outcomes of patients who experience POPF after pancreatic cancer resection remain inconclusive. The purpose of this study was to evaluate the impact of POPF on the long-term survival of patients undergoing pancreatic cancer resection. METHODS: A systematic review and meta-analysis were performed for studies comparing survival outcomes in patients with or without POPF following…

The impact of MRI on real-world staging pathways and management timelines in pancreatic cancer: A systematic review.

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2026 · PMID 41996777

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis, and accurate staging is crucial to avoid unnecessary surgery. MRI may improve the detection of occult liver metastases when compared with CT. The impact of adding MRI on treatment timelines and cost-effectiveness remains uncertain. This systematic review synthesises the available evidence of incorporating MRI alongside CT for pre-operative staging of pancreatic cancer. METHODS: We systematically searched MEDLINE, Embase, Web of Science, and t…

Robotic pancreaticoduodenectomy with venous resection and reconstruction: a systematic review of perioperative, vascular, oncological and survival outcomes.

Journal of robotic surgery · 2026 · PMID 42474838

Robotic pancreaticoduodenectomy with venous resection and reconstruction (RPD-VR) is one of the most technically challenging procedures in hepatopancreaticobiliary surgery. While acceptance of robotic pancreaticoduodenectomy is growing, the safety, feasibility, and oncologic adequacy of combined portal vein (PV) and/or superior mesenteric vein (SMV) resection remain incompletely defined. A systematic review was conducted following PRISMA guidelines. PubMed/MEDLINE, Scopus and the Cochrane Library were searched from…

Incidence and Determinants of Steatotic Liver Disease after Pancreaticoduodenectomy: A Systematic Review and Meta-Analysis.

Journal of hepato-biliary-pancreatic sciences · 2026 · PMID 41879125

BACKGROUND: Steatotic liver disease (SLD) is an unrecognized complication after pancreaticoduodenectomy (PD) and may affect nutrition and long-term recovery. This meta-analysis estimated the incidence of SLD after PD and identified its clinical and surgical risk factors. METHODS: MEDLINE and EMBASE were searched through March 2025 for studies reporting incident SLD after PD. Random-effects models generated pooled incidence and risk estimates. Subgroup, meta-regression, and sensitivity analyses assessed heterogeneit…

Serum CA19.9 for Detecting High-Grade Dysplasia and Invasive Carcinoma in Patients With Intraductal Papillary Mucinous Neoplasm: A Systematic Review and Meta-Analysis.

JAMA network open · 2026 · PMID 42360746

IMPORTANCE: Current guidelines recommend routine assessment of serum carbohydrate antigen 19.9 (CA19.9) at diagnosis and during follow-up of patients with intraductal papillary mucinous neoplasm (IPMN) to detect high-grade dysplasia (HGD) and invasive carcinoma (IC). Guidelines consider an elevated serum CA19.9 level (≥37 U/mL) a worrisome feature and a relative indication for surgery. OBJECTIVE: To evaluate the diagnostic accuracy of CA19.9 for identifying patients with IPMN at high risk of HGD and IC. DATA SOURCE…

Implications and risk of new versus persisting intraductal papillary mucinous neoplasms after pancreatic surgery: meta-analysis.

BJS open · 2026 · PMID 42441942

BACKGROUND: Interpretation of recurrence following resection of intraductal papillary mucinous neoplasms (IPMNs) is hindered by inconsistent terminology and outcome reporting. A distinction between metachronous/de novo IPMN development, progression of residual disease, and true recurrence of invasive entities is rarely considered. METHODS: A systematic review and meta-analysis were conducted following PRISMA and Cochrane guidelines (PROSPERO-ID: 1009399). The primary endpoint was postoperative recurrence of non-inv…

Efficacy and safety of radical antegrade modular pancreatosplenectomy versus standard radical pancreatosplenectomy for pancreatic body/tail cancer: A systematic review and meta-analysis.

Surgery · 2026 · PMID 41924794

OBJECTIVE: To compare the efficacy and safety of radical antegrade modular pancreatosplenectomy with standard radical pancreatosplenectomy in the treatment of pancreatic body and tail cancer. METHODS: A comprehensive literature search was conducted in the PubMed, EMBASE, and Web of Science databases from January 2003 to July 2025. Pooled odds ratios, hazard ratios, or mean differences were calculated with 95% CIs. The analysis was performed using RevMan 5.4.1 and R 4.3.0. RESULTS: Sixteen studies involving 2,136 pa…

Association between weight loss and overall survival in patients with pancreatic cancer: a meta-analysis.

European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) · 2026 · PMID 41017436

Weight loss is a common symptom among patients with pancreatic cancer, often indicating tumor progression or poor nutritional status. This meta-analysis aimed to investigate the association between weight loss and overall survival in individuals with pancreatic cancer, synthesizing evidence from observational studies. A thorough search of the PubMed, Embase, and Web of Science databases was conducted up to 18 May 2025. Eligible studies must have reported quantitative associations between percent weight loss and ove…

Neoadjuvant Treatment Versus Upfront Surgery for Resectable Pancreatic Ductal Adenocarcinoma-A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Medicina (Kaunas, Lithuania) · 2026 · PMID 42356062

Background and Objectives: The role of neoadjuvant or perioperative treatment in anatomically resectable pancreatic ductal adenocarcinoma (PDAC) remains intensely debated, in part because prior evidence syntheses have often pooled resectable and borderline-resectable disease. We aim to evaluate the efficacy and safety of neoadjuvant or perioperative treatment versus upfront surgery in trial-defined resectable PDAC using randomized evidence only. Materials and Methods: We performed a systematic review and meta-analy…

Systematic Review and Pooled Analysis of 1,021 Children With Pancreatic Tumors.

The Journal of surgical research · 2026 · PMID 42335633

INTRODUCTION: Although relatively rare, pediatric pancreatic tumors have been increasingly reported in the literature. Our aim was to systematically review the literature on the clinical characteristics, management, and outcomes of pediatric pancreatic tumors. METHODS: We performed a systematic review of the MEDLINE, Scopus, Web of Science, and Cochrane Library databases (end-of-search date: June 2022) according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. RESULTS: Sixty-four…

Beyond body surface area: CT-derived body composition as a predictor of chemotherapy toxicity and survival in pancreatic ductal adenocarcinoma: a systematic review.

Cancer treatment reviews · 2026 · PMID 42361440

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is characterised by a high prevalence of severe muscle wasting (sarcopenia) and fatty muscle infiltration (myosteatosis), yet chemotherapy dosing still relies on body surface area (BSA), a metric that does not reflect individual patients' lean body mass (LBM) or muscle quality. A growing body of evidence from oncology meta-analyses demonstrates that low skeletal muscle mass (sarcopenia) independently predicts chemotherapy toxicity across multiple cancer types, and…

Short-Term Outcomes of Arterial Divestment in Pancreatic Cancer: A Systematic Review and Single Arm Meta-Analysis of Observational Studies.

World journal of surgery · 2026 · PMID 41903157

BACKGROUND: The present study aimed to review and analyze the impact of arterial divestment during pancreatic surgery on short-term outcomes. METHODS: PubMed, Embase, Web of Science, and the Cochrane Library were searched. Outcomes of interest included perioperative parameters, resection margins, morbidity, and mortality. Analysis was performed using the meta package in R. RESULTS: Five observational studies comprising 554 patients were included. Two hundred twelve patients had upfront surgery, and 342 patients had…

Reverse-Bevel (ProCore) EUS-Guided Fine-Needle Biopsy for Solid Pancreatic Mass Lesions: a GRADE-Assessed Systematic Review and Meta-Analysis of Prospective Randomized Trials.

Journal of gastrointestinal cancer · 2026 · PMID 42406286

BACKGROUND AND AIMS: Endoscopic ultrasound-guided tissue acquisition is used to diagnose pancreatic mass lesions, but optimal needle selection remains uncertain. Reverse bevel ProCore fine needle biopsy (FNB) needles aim to enhance histologic procurement and reduce sampling burden; randomized evidence versus standard fine needle aspiration (FNA) is limited. We synthesized randomized trials to compare diagnostic performance, efficiency, and safety. METHODS: We searched MEDLINE (PubMed), Embase, Cochrane CENTRAL, Sco…

Advancing precision immunotherapy in advanced pancreatic cancer: a systematic review and meta-analysis of first-line ICI-based combinations.

Frontiers in immunology · 2026 · PMID 42500667

OBJECTIVE: Pancreatic ductal adenocarcinoma (PDAC) has an extremely poor prognosis. Immune checkpoint inhibitor (ICI) monotherapy has shown limited efficacy in PDAC, whereas the potential clinical value of first-line ICI-based combination regimens remains unclear. Through a systematic review and meta-analysis, this study aimed to evaluate the efficacy and safety of first-line ICI-based combination regimens in advanced PDAC. METHODS: PubMed, Embase, The Cochrane Library, Scopus, Web of Science, CNKI, Wanfang Data, V…

The outcomes of surgical resection versus ablation of liver metastases from neuroendocrine tumors: A systematic review.

Hepatobiliary & pancreatic diseases international : HBPD INT · 2026 · PMID 42177126

BACKGROUND: Neuroendocrine liver metastases (NLMs) from gastroenteropancreatic neuroendocrine tumors (GEP-NETs) significantly impact morbidity and mortality. While surgical resection remains the standard treatment, radiofrequency ablation (RFA) has emerged as an alternative for unresectable cases. This systematic review compared the oncological outcomes of surgical resection and RFA. DATA SOURCES: A systematic search of PubMed, Web of Science, and Scopus identified studies published between 2014 and 2025. Eligible …

REDISCOVER guidelines for borderline-resectable and locally advanced pancreatic cancer: management algorithm, unanswered questions, and future perspectives.

Updates in surgery · 2024 · PMID 38684573

The REDISCOVER guidelines present 34 recommendations for the selection and perioperative care of borderline-resectable (BR-PDAC) and locally advanced ductal adenocarcinoma of the pancreas (LA-PDAC). These guidelines represent a significant shift from previous approaches, prioritizing tumor biology over anatomical features as the primary indication for resection. Condensed herein, they provide a practical management algorithm for clinical practice. However, the guidelines also highlight the need to redefine LA-PDAC …

Statins and the risk of pancreatic cancer: A systematic review and meta-analysis of 2,797,186 patients.

Cardiology journal · 2024 · PMID 35373328

BACKGROUND: Statin use in many studies is related to the improvement of a patients' condition including reducing the risk of various malignancies. Herein, is a systematic review and meta-analysis to examine the evidence on the association between statin therapy and the risk of the occurrence of pancreatic cancer, mainly in terms of decreased risk of developing pancreatic cancer among patients using statin therapy in the long-term perspective. METHODS: PubMed, Web of Science, Scopus and Cochrane Central Register of …

Evaluating the Rates of Pancreatitis and Pancreatic Cancer Among GLP-1 Receptor Agonists: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

Endocrinology, diabetes & metabolism · 2025 · PMID 40988099

AIMS: This meta-analysis evaluates the rates of pancreatitis/pancreatic cancer among glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in randomised controlled trials (RCTs). METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), a systematic search was performed in PubMed, Embase, and Cochrane Library for GLP-1 RA RCTs that evaluated pancreatitis/pancreatic cancer. A meta-analysis was conducted to evaluate this risk; subgroup analysis was performed with and without …

Pancreatic Cancer in Celiac Disease Patients-A Systematic Review and Meta-Analysis.

International journal of environmental research and public health · 2023 · PMID 36674320

Background: Celiac disease (CD) is an autoimmune enteropathy affecting approximately 1% of the population and is associated with an increased risk of enteropathy-associated T-cell lymphoma and small bowel adenocarcinoma, whereas the association between CD and other malignancies is unclear. Since pancreatic cancer (PC) remains one of the most lethal neoplasms and its incidence is increasing despite numerous ongoing research on diagnostic biomarkers and novel therapies, we aimed to investigate whether CD has an impac…

Predictors for Long-Term Survival After Resection of Pancreatic Ductal Adenocarcinoma: A Systematic Review and Meta-Analysis.

Annals of surgical oncology · 2024 · PMID 38710910

BACKGROUND: Improved systemic therapy has made long term (≥ 5 years) overall survival (LTS) after resection of pancreatic ductal adenocarcinoma (PDAC) increasingly common. However, a systematic review on predictors of LTS following resection of PDAC is lacking. METHODS: The PubMed, Embase, Scopus, and Cochrane CENTRAL databases were systematically searched from inception until March 2023. Studies reporting actual survival data (based on follow-up and not survival analysis estimates) on factors associated with LTS w…

Safety and efficacy of liposomal irinotecan as the second-line treatment for advanced pancreatic cancer: A systematic review and meta-analysis.

Critical reviews in oncology/hematology · 2024 · PMID 38735505

INTRODUCTION: Nanoliposomal irinotecan (nal-IRI) is a novel regimen for pancreatic cancer, featuring a longer half-life and an increased area under the concentration-time curve. This study aims to assess the safety and efficacy of nal-IRI as a second-line treatment for advanced pancreatic cancer. METHODS: A systemic literature search was conducted based on articles published before September 26th, 2023 in databases, including PubMed, Cochrane Library, EMBASE and Web of Science. The fixed effects model was used to c…

NALIRIFOX, FOLFIRINOX, and Gemcitabine With Nab-Paclitaxel as First-Line Chemotherapy for Metastatic Pancreatic Cancer: A Systematic Review and Meta-Analysis.

JAMA network open · 2024 · PMID 38190183

IMPORTANCE: The NAPOLI 3 trial showed the superiority of fluorouracil, leucovorin, liposomal irinotecan, and oxaliplatin (NALIRIFOX) over the combination of gemcitabine and nab-paclitaxel (GEM-NABP) as first-line treatment of metastatic pancreatic ductal adenocarcinoma (PDAC). Analyses comparing NALIRIFOX and GEM-NABP with fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) have not yet been reported. OBJECTIVE: To derive survival, response, and toxic effects data from phase 3 clinical trials and com…

Clinical outcomes of liposomal irinotecan in patients with advanced pancreatic cancer previously treated with conventional irinotecan: A meta-analysis of real-world evidence.

Cancer · 2024 · PMID 38985839

BACKGROUND: Pivotal clinical trials supported survival benefits of liposomal irinotecan (nal-IRI) plus fluorouracil/leucovorin in patients with pancreatic ductal adenocarcinoma (PDAC) who previously received gemcitabine-based therapy. There are concerns about the benefits of nal-IRI in patients who received FOLFIRINOX (combined fluorouracil, leucovorin, IRI, and oxaliplatin) because of potential cross-resistance to IRI. The objective of this meta-analysis was to characterize the impact of the previous receipt of IR…

Homologous Recombination Deficiency in Pancreatic Cancer: A Systematic Review and Prevalence Meta-Analysis.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2021 · PMID 34197182

PURPOSE: To analyze the prevalence of homologous recombination deficiency (HRD) in patients with pancreatic ductal adenocarcinoma (PDAC). MATERIALS AND METHODS: We conducted a systematic review and meta-analysis of the prevalence of HRD in PDAC from PubMed, Scopus, and Cochrane Library databases, and online cancer genomic data sets. The main outcome was pooled prevalence of somatic and germline mutations in the better characterized HRD genes (BRCA1, BRCA2, PALB2, ATM, ATR, CHEK2, RAD51, and the FANC genes). The sec…

Gut microbiome changes associated with chronic pancreatitis and pancreatic cancer: a systematic review and meta-analysis.

International journal of surgery (London, England) · 2024 · PMID 38847785

BACKGROUND: The study of changes in the microbiome in chronic pancreatitis (CP) and pancreatic ductal adenocarcinoma (PDAC) holds significant potential for developing noninvasive diagnostic tools as well as innovative interventions to alter the progression of diseases. This systematic review and meta-analysis aimed to analyze in detail the taxonomic and functional characteristics of the gut microbiome in patients with CP and PDAC. METHODS: Two researchers conducted a systematic search across public databases to gat…

Comparison of first-line chemotherapy regimens in unresectable locally advanced or metastatic pancreatic cancer: a systematic review and Bayesian network meta-analysis.

The Lancet. Oncology · 2024 · PMID 39542008

BACKGROUND: In advanced pancreatic ductal adenocarcinoma (PDAC), first-line chemotherapy is the standard of care. Due to the absence of head-to-head comparisons in clinical trials, we performed this systematic review and network meta-analysis to compare treatment options for PDAC in terms of their efficacy and toxicity. METHODS: PubMed, the Cochrane Central Register of Controlled Trials, Embase, and oncological meetings websites were searched until Nov 15, 2023. We included phase 2-3 randomised controlled trials pu…

Comparison of different second line treatments for metastatic pancreatic cancer: a systematic review and network meta-analysis.

BMC gastroenterology · 2023 · PMID 37337148

BACKGROUND: In metastatic pancreatic ductal adenocarcinoma (mPDAC), first line treatment options usually include combination regimens of folinic acid, 5-fluorouracil (5-FU), irinotecan, and oxaliplatin (FOLFIRINOX or mFOLFIRINOX) or gemcitabine based regimens such as in combination with albumin-bound paclitaxel (GEM + nab-PTX). After progression, multiple regimens including NALIRI + 5-FU and folinic acid, FOLFIRINOX, 5-FU-based oxaliplatin doublets (OFF, FOLFOX, or XELOX), or 5-FU-based monotherapy (FL, capecitabin…

Primary Pancreatic GIST - A-Single Centre Case Series and Systematic Review of Literature.

Journal of gastrointestinal cancer · 2024 · PMID 38324136

PURPOSE: GISTs arising from organs outside GI tract are defined as extragastrointestinal GISTs (EGIST). The majority of EGISTs arise from small intestinal mesentry, mesocolon, omentum, retroperitoneum, abdominal wall, liver and pancreas with pancreas comprising less than 5% of it. Due to limited data, it is unknown if the results of GIST can be generalised for EGISTs. We thereby present the largest single-centre case series of primary pancreatic GIST so far with review of existing literature. METHODS: A total of 9 …

Sweetened Beverages Consumption and Pancreatic Cancer: A Meta-Analysis.

Nutrition and cancer · 2019 · PMID 30849232

No study has summarized earlier findings on the association of sweetened beverages (SBs) consumption and risk of Pancreatic Cancer (PC). This systematic review and meta-analysis was conducted to systematically review available observational studies that examined the association of SB consumption with risk of PC. Relevant papers published up to December 2017 were searched through PubMed, MEDLINE, SCOPUS, EMBASE, and Google Scholar databases, using relevant keywords. Cohort and case-control studies that examined the …

Quantitative CT perfusion imaging in patients with pancreatic cancer: a systematic review.

Abdominal radiology (New York) · 2022 · PMID 34223961

Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer-related death with a 5-year survival rate of 10%. Quantitative CT perfusion (CTP) can provide additional diagnostic information compared to the limited accuracy of the current standard, contrast-enhanced CT (CECT). This systematic review evaluates CTP for diagnosis, grading, and treatment assessment of PDAC. The secondary goal is to provide an overview of scan protocols and perfusion models used for CTP in PDAC. The search strategy combine…

Exosomes as prognostic biomarkers in pancreatic ductal adenocarcinoma-a systematic review and meta-analysis.

Translational research : the journal of laboratory and clinical medicine · 2022 · PMID 35066189

Extensive research is focused on the role of liquid biopsy in pancreatic cancer since reliable diagnostic and follow-up biomarkers represent an unmet need for this highly lethal malignancy. We performed a systematic review and meta-analysis on the prognostic value of exosomal biomarkers in pancreatic ductal adenocarcinoma (PDAC). MEDLINE, Embase, Scopus, Web of Science, and CENTRAL were systematically searched on the 18th of January, 2021 for studies reporting on the differences in overall (OS) and progression-free…

Endoscopic ultrasound-guided injectable therapy for pancreatic cancer: A systematic review.

World journal of gastroenterology · 2022 · PMID 35800184

BACKGROUND: Given the low survival rate in pancreatic cancer, new therapeutic techniques have been explored, especially for unresectable or borderline resectable disease. Endoscopic ultrasound (EUS) provides real-time imaging and minimally invasive access for local and targeted injection of anti-tumor agents directly into the pancreatic tumor. Limited studies have been reported using this technique for the treatment of pancreatic ductal adenocarcinoma (PDAC). AIM: To evaluate the progress made with EUS-guided injec…

Transarterial Radioembolization for Hepatic Metastases of Pancreatic Adenocarcinoma: A Systematic Review.

Journal of vascular and interventional radiology : JVIR · 2022 · PMID 36084842

PURPOSE: To assess the safety and effectiveness of transarterial radioembolization (TARE) in the treatment of hepatic metastases from pancreatic ductal adenocarcinoma (PDAC). MATERIALS AND METHODS: A systematic search of the Embase and MEDLINE databases was conducted using keywords and Medical Subject Headings terms related to TARE and hepatic metastases from PDAC. Observational studies and clinical trials reporting overall survival (OS), hepatic progression-free survival (hPFS), or tumor response after TARE were i…

Surgical management of familial pancreatic cancer: a systematic review of the literature.

ANZ journal of surgery · 2022 · PMID 35758214

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is the third most common cause of cancer-related mortality. The fact that the vast majority of patients with PDAC are diagnosed at an advanced stage highlights the need of early diagnosis. As hereditary factors are associated with approximately 5% of all PDAC cases, a screening programme to these high-risk individuals (HRI) has been proposed. The aim of screening methods is to identify selected group of patients with morphological abnormalities at an early stage, …

Systematic review and meta-analysis on targeted therapy in advanced pancreatic cancer.

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · 2016 · PMID 26852170

AIM: A systematic review and meta-analysis from literature has been performed to assess the impact of targeted therapy in advanced pancreatic cancer. METHODS: By searching different literature databases and major cancer meetings proceedings, data from all randomized clinical trials designed to investigate molecular targeted agents in the treatment of advanced pancreatic cancer were collected. The time-frame between January 2007 and March 2015 was selected. Data on predefined end-points, including overall survival, …

Defining oligometastatic pancreatic cancer: a systematic review and critical synthesis of consensus.

ESMO open · 2023 · PMID 37988953

BACKGROUND: Small retrospective series suggest that local consolidative treatment (LCT) may improve survival in oligometastatic pancreatic ductal adenocarcinoma (PDAC). However, no uniform definition of oligometastatic disease (OMD) in PDAC exists; this impedes meaningful conclusions. PATIENTS AND METHODS: A systematic literature search using PubMed, Web of Science, and Cochrane CENTRAL registries for studies and protocols reporting on definitions and/or LCT of OMD in PDAC was performed. The primary endpoint was th…

An Updated Meta-analysis of Pancreatic Cancer Risk in Patients with Inflammatory Bowel Disease.

Journal of gastrointestinal cancer · 2025 · PMID 40603749

OBJECTIVE: This meta-analysis aims to systematically evaluate the relationship between inflammatory bowel disease (IBD) and the risk of developing pancreatic cancer (PC). DESIGN: Systematic review and meta-analysis. METHOD: We searched PubMed (Medline), Web of Science, and Scopus up until September 8, 2024. To evaluate heterogeneity among the studies, we used the chi-square test and the I2 statistic. An I2 value exceeding 50% was considered indicative of substantial heterogeneity. We calculated estimates of odds ra…

Risk of pancreatic cancer and high-grade dysplasia in resected main-duct and mixed-type intraductal papillary mucinous neoplasms: A prevalence meta-analysis.

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2025 · PMID 40117982

BACKGROUND: Current guidelines recommend the resection of main duct- (MD) and mixed-type (MT) intraductal papillary mucinous neoplasms (IPMN) based on specific risk criteria to prevent or treat pancreatic cancer in selected patients. This paradigm follows high rates of malignancy observed in published surgical series. The aim of this systematic review and meta-analysis was to provide robust, pooled rates of invasive carcinoma (IC) and high-grade dysplasia (HGD) in resected MD- and MT-IPMNs of the pancreas. METHODS:…

Life Course Trajectories of Body Mass Index and Risk of Cancer in Adulthood: Systematic Review and Meta-Analysis.

Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026 · PMID 41787663

OBJECTIVE: This systematic review and meta-analysis aimed to identify common life-course body mass index (BMI) trajectories (childhood/adulthood to adulthood) and their impact on risk of cancer overall and cancer at different sites in adulthood. METHODS: Observational studies were identified that assessed the association of BMI trajectories with cancer risks from databases published in English. The pooled effect sizes were estimated using a random-effects model. FINDINGS: A total of 24 eligible studies were include…

Improving Outcomes in Pancreatic Adenocarcinoma: A Systematic Review of Immunotherapy in Multimodal Treatment.

Medicina (Kaunas, Lithuania) · 2025 · PMID 40572765

Background: Despite advances in chemotherapy and supportive care, pancreatic ductal adenocarcinoma (PDAC) continues to carry a dismal prognosis, with a five-year survival rate of approximately 13%. While immunotherapy has revolutionized treatment for several malignancies, its efficacy in PDAC remains limited. Recent research has shifted focus toward integrating immunotherapy with chemotherapy, radiation, and targeted therapies in an effort to overcome therapeutic resistance and improve outcomes. Ongoing clinical tr…

ACR Appropriateness Criteria® Staging and Follow-Up of Pancreatic Neuroendocrine Tumors.

Journal of the American College of Radiology : JACR · 2026 · PMID 41823937

Accurate staging and appropriate follow-up imaging of pancreatic neuroendocrine tumors (PNET) are essential for guiding management and optimizing outcomes. This document provides evidence-based recommendations for the imaging evaluation of patients with PNET across six clinical variants: local staging, staging for metastatic disease, surveillance postresection, follow-up after treatment of liver-dominant and non-liver dominant disease, and follow-up of untreated disease. Contrast-enhanced CT is usually appropriate …

Early onset pancreatic Cancer: epidemiology, molecular features, and clinical outcomes.

Cancer treatment reviews · 2026 · PMID 42341370

Background Early onset pancreatic cancer (EOPC), defined for the primary analysis as pancreatic ductal adenocarcinoma (PDAC) diagnosed before the age of 50 years, is an increasingly recognised clinical and epidemiological entity. Because published studies use heterogeneous age thresholds, the present review prespecified <50 years as the main definition and interpreted studies using other cutoffs in sensitivity or narrative analyses. Methods We systematically searched PubMed, EMBASE, and the Cochrane Library for stu…

pRECIST: Guidelines for Response Criteria for Use in Trials Testing Therapeutics in Pancreatic Cancer.

Pancreas · 2026 · PMID 41941588

IMPORTANCE: Pancreatic tumor response to treatment remains challenging and varies greatly. In order to establish a standardized approach to measuring and evaluating pancreatic tumor metabolic activity (MA), a consensus guideline called Pancreatic RECIST (pRECIST) was developed. This guideline is based on modified Response Evaluation Criteria in Solid Tumors (RECIST version 1.1), incorporating concurrent CT/PET scan quantitative assessments. OBJECTIVE: The aims were to ensure consistent design, data collection, and …

Association of multidisciplinary team management with clinical outcomes in hepatobiliary and pancreatic malignancies: A systematic review and meta-analysis.

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2026 · PMID 42314305

BACKGROUND: Multidisciplinary team (MDT) management is widely endorsed for complex hepatobiliary and pancreatic (HBP) malignancies. However, robust systematic evidence evaluating its survival benefits and heterogeneity across distinct anatomical sites remains limited. METHODS: Our study systematically searched four databases from their inception through Dec 17, 2025, for studies comparing MDT versus non-MDT care in HBP malignancies. The primary outcome was overall survival or mortality risk. Secondary outcomes incl…

Impact of postoperative pancreatic fistula (POPF) on long-term outcomes of patients who underwent pancreatic cancer resection: systematic review and meta-analysis.

Surgical oncology · 2026 · PMID 42242032

INTRODUCTION: Postoperative pancreatic fistula (POPF) is a major complication resulting from pancreatic resection. The long-term oncological outcomes of patients who experience POPF after pancreatic cancer resection remain inconclusive. The purpose of this study was to evaluate the impact of POPF on the long-term survival of patients undergoing pancreatic cancer resection. METHODS: A systematic review and meta-analysis were performed for studies comparing survival outcomes in patients with or without POPF following…

Incidence and Determinants of Steatotic Liver Disease after Pancreaticoduodenectomy: A Systematic Review and Meta-Analysis.

Journal of hepato-biliary-pancreatic sciences · 2026 · PMID 41879125

BACKGROUND: Steatotic liver disease (SLD) is an unrecognized complication after pancreaticoduodenectomy (PD) and may affect nutrition and long-term recovery. This meta-analysis estimated the incidence of SLD after PD and identified its clinical and surgical risk factors. METHODS: MEDLINE and EMBASE were searched through March 2025 for studies reporting incident SLD after PD. Random-effects models generated pooled incidence and risk estimates. Subgroup, meta-regression, and sensitivity analyses assessed heterogeneit…

Robotic pancreaticoduodenectomy with venous resection and reconstruction: a systematic review of perioperative, vascular, oncological and survival outcomes.

Journal of robotic surgery · 2026 · PMID 42474838

Robotic pancreaticoduodenectomy with venous resection and reconstruction (RPD-VR) is one of the most technically challenging procedures in hepatopancreaticobiliary surgery. While acceptance of robotic pancreaticoduodenectomy is growing, the safety, feasibility, and oncologic adequacy of combined portal vein (PV) and/or superior mesenteric vein (SMV) resection remain incompletely defined. A systematic review was conducted following PRISMA guidelines. PubMed/MEDLINE, Scopus and the Cochrane Library were searched from…

Implications and risk of new versus persisting intraductal papillary mucinous neoplasms after pancreatic surgery: meta-analysis.

BJS open · 2026 · PMID 42441942

BACKGROUND: Interpretation of recurrence following resection of intraductal papillary mucinous neoplasms (IPMNs) is hindered by inconsistent terminology and outcome reporting. A distinction between metachronous/de novo IPMN development, progression of residual disease, and true recurrence of invasive entities is rarely considered. METHODS: A systematic review and meta-analysis were conducted following PRISMA and Cochrane guidelines (PROSPERO-ID: 1009399). The primary endpoint was postoperative recurrence of non-inv…

Association between weight loss and overall survival in patients with pancreatic cancer: a meta-analysis.

European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) · 2026 · PMID 41017436

Weight loss is a common symptom among patients with pancreatic cancer, often indicating tumor progression or poor nutritional status. This meta-analysis aimed to investigate the association between weight loss and overall survival in individuals with pancreatic cancer, synthesizing evidence from observational studies. A thorough search of the PubMed, Embase, and Web of Science databases was conducted up to 18 May 2025. Eligible studies must have reported quantitative associations between percent weight loss and ove…

Systematic Review and Pooled Analysis of 1,021 Children With Pancreatic Tumors.

The Journal of surgical research · 2026 · PMID 42335633

INTRODUCTION: Although relatively rare, pediatric pancreatic tumors have been increasingly reported in the literature. Our aim was to systematically review the literature on the clinical characteristics, management, and outcomes of pediatric pancreatic tumors. METHODS: We performed a systematic review of the MEDLINE, Scopus, Web of Science, and Cochrane Library databases (end-of-search date: June 2022) according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. RESULTS: Sixty-four…

Beyond body surface area: CT-derived body composition as a predictor of chemotherapy toxicity and survival in pancreatic ductal adenocarcinoma: a systematic review.

Cancer treatment reviews · 2026 · PMID 42361440

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is characterised by a high prevalence of severe muscle wasting (sarcopenia) and fatty muscle infiltration (myosteatosis), yet chemotherapy dosing still relies on body surface area (BSA), a metric that does not reflect individual patients' lean body mass (LBM) or muscle quality. A growing body of evidence from oncology meta-analyses demonstrates that low skeletal muscle mass (sarcopenia) independently predicts chemotherapy toxicity across multiple cancer types, and…

Advancing precision immunotherapy in advanced pancreatic cancer: a systematic review and meta-analysis of first-line ICI-based combinations.

Frontiers in immunology · 2026 · PMID 42500667

OBJECTIVE: Pancreatic ductal adenocarcinoma (PDAC) has an extremely poor prognosis. Immune checkpoint inhibitor (ICI) monotherapy has shown limited efficacy in PDAC, whereas the potential clinical value of first-line ICI-based combination regimens remains unclear. Through a systematic review and meta-analysis, this study aimed to evaluate the efficacy and safety of first-line ICI-based combination regimens in advanced PDAC. METHODS: PubMed, Embase, The Cochrane Library, Scopus, Web of Science, CNKI, Wanfang Data, V…

The outcomes of surgical resection versus ablation of liver metastases from neuroendocrine tumors: A systematic review.

Hepatobiliary & pancreatic diseases international : HBPD INT · 2026 · PMID 42177126

BACKGROUND: Neuroendocrine liver metastases (NLMs) from gastroenteropancreatic neuroendocrine tumors (GEP-NETs) significantly impact morbidity and mortality. While surgical resection remains the standard treatment, radiofrequency ablation (RFA) has emerged as an alternative for unresectable cases. This systematic review compared the oncological outcomes of surgical resection and RFA. DATA SOURCES: A systematic search of PubMed, Web of Science, and Scopus identified studies published between 2014 and 2025. Eligible …

Pancreatic acinar cell cystadenoma: single-center experiences and a systematic review.

Scandinavian journal of gastroenterology · 2026 · PMID 42067962

AIMS: Pancreatic cystic lesions (PCLs) range from benign to malignant, creating diagnostic and therapeutic challenges. While most PCLs are serous or mucinous neoplasms, rare entities such as acinar cell cystadenoma (ACC) remain poorly characterized. This study reports a tertiary center cohort and a systematic literature review. METHODS: We retrospectively analyzed 23 ACC patients at Karolinska University Hospital. A systematic review was performed following PRISMA guidelines. RESULTS: In our cohort (median age 67.0…

Defining textbook outcome for distal pancreatectomy by systematic review. Is it clinically relevant?

Surgery · 2026 · PMID 42134067

BACKGROUND: A textbook outcome is a composite score of individual metrics that report an ideal outcome for a given surgery. The objectives of this study were to develop and validate a textbook outcome definition for distal pancreatectomy. METHODS: PubMed, Embase, and Web of Science databases were searched until October 1, 2024 for this systematic review, and studies that evaluated textbook outcome for distal pancreatectomy were selected. Textbook outcome metrics were chosen by data strength and validated by reviewi…

Endoscopic ultrasound-guided radiofrequency ablation of pancreatic insulinoma.

Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2026 · PMID 42417742

BACKGROUND: Insulinoma is a rare pancreatic neuroendocrine tumor (pNET) arising from beta cells, leading to excessive insulin secretion and life-threatening hypoglycemia. While surgical resection remains the gold standard, endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) has emerged as a minimally invasive alternative, particularly for patients unfit for surgery. AIMS: A meta-analysis was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines to c…

Primary Pancreatic GIST - A-Single Centre Case Series and Systematic Review of Literature.

Journal of gastrointestinal cancer · 2024 · PMID 38324136

PURPOSE: GISTs arising from organs outside GI tract are defined as extragastrointestinal GISTs (EGIST). The majority of EGISTs arise from small intestinal mesentry, mesocolon, omentum, retroperitoneum, abdominal wall, liver and pancreas with pancreas comprising less than 5% of it. Due to limited data, it is unknown if the results of GIST can be generalised for EGISTs. We thereby present the largest single-centre case series of primary pancreatic GIST so far with review of existing literature. METHODS: A total of 9 …

Textbook outcomes in pancreatic surgery: a systematic review.

Cirugia espanola · 2026 · PMID 41864456

Pancreatectomy is associated with high morbidity and mortality, making the evaluation of surgical outcomes essential. The textbook outcome in pancreatic surgery (TOPS) combines multiple quality metrics into a single composite endpoint, providing a more representative assessment of optimal surgical care. Following PRISMA guidelines, a literature search was conducted for studies on postoperative TOPS after pancreatectomy, analyzing methodology, rates, associated factors, inter-hospital variability, and overall findin…

Activity and Physiological Stress Within 90 Days After Minimally Invasive and Open Pancreatoduodenectomy: A Predefined Analysis of the DIPLOMA-2 Randomized Clinical Trial.

JAMA surgery · 2026 · PMID 42160093

IMPORTANCE: Minimally invasive pancreatoduodenectomy (MIPD) aims to improve postoperative recovery compared with open pancreatoduodenectomy (OPD). However, it is unclear whether the benefits of MIPD extend beyond the initial hospital stay. OBJECTIVE: To assess postoperative recovery after hospital discharge-using activity tracking-in patients with upfront resectable neoplasm in the pancreatic head or periampullary region, comparing MIPD with OPD. DESIGN, SETTING, AND PARTICIPANTS: The patient-blinded DIPLOMA-2 rand…

Photon-counting CT in gastrointestinal malignancies: a scoping review.

European journal of radiology · 2026 · PMID 42102569

BACKGROUND: Photon-Counting computed tomography(PCCT) offers superior spatial resolution, improved contrast-to-noise ratio and reduced radiation dose compared with conventional CT. This scoping review maps and synthesizes clinical evidence on PCCT applications in gastrointestinal (GI) oncology following the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines METHODS: A systematic search of PubMed, Embase, Web of Science and Cochrane Library (January 2017-December 2025) identified studies evaluating PCCT in…

Modern Approaches to Diagnosis and Evaluation of Survival Prognosis in Patients with Pancreatic Cancer.

International journal of molecular sciences · 2026 · PMID 42450138

Pancreatic cancer is among the most aggressive malignancies, and late diagnosis remains a key challenge. For a systematic review of pancreatic cancer diagnosis and prognosis, Scopus and Web of Science databases were used for the period from 2016 to 2026. The search query included the following keywords and their combinations: pancreatic cancer, diagnosis, early detection, prognosis, biomarkers, metabolomic profiling, CA19-9, microbiome, metagenomic changes, circulating tumor DNA, genomic analysis. Inclusion criteri…

Impact of cytoreductive surgery with HIPEC in the treatment of pancreatic cancer with peritoneal carcinomatosis: A systematic review.

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2026 · PMID 42229165

Pancreatic cancer with peritoneal metastases is associated with a particularly poor prognosis under standard systemic therapy. This systematic review evaluates the role of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in this patient population, focusing on survival, recurrence, and treatment-related morbidity and mortality. Following PRISMA guidelines, a systematic search was conducted across MEDLINE, Web of Science, and SCOPUS. Study quality was assessed using the Methodologica…

Validation of magnetic resonance imaging for quantification of intrapancreatic fat deposition using phantom and histologic comparators: a systematic review and meta-analysis.

European radiology · 2026 · PMID 41872343

OBJECTIVES: Recent insights into understanding intrapancreatic fat deposition (IPFD) and its relationship with common pancreatic diseases have opened new opportunities for their prevention and treatment. This progress underscores the need for an accurate and universally applicable non-invasive imaging modality tailored for IPFD quantification. Chemical shift-encoded magnetic resonance imaging (CSE-MRI) is a non-ionising, time-efficient technique thought to be naturally fit for IPFD quantification because of its exc…

Primary pancreatic paraganglioma: a systematic review.

Endocrine · 2026 · PMID 42440163

BACKGROUND: Pancreatic paraganglioma (P-PGL) is an exceptionally rare neuroendocrine tumor, often misdiagnosed as other pancreatic neoplasms due to overlapping clinical and radiological features. Evidence is limited to case reports and small series, and standardized diagnostic and therapeutic strategies are lacking. OBJECTIVE: To systematically review published cases of P-PGL, summarizing clinical presentation, diagnostic approaches, management strategies, and outcomes. METHODS: A systematic literature search was p…

Leukotriene receptor antagonist drugs as potential chemopreventive agents: A systematic review and meta-analysis of cancer risk in asthmatic patients.

Prostaglandins, leukotrienes, and essential fatty acids · 2026 · PMID 41864069

Inflammation represents a critical factor in carcinogenesis, and cysteinyl leukotrienes (CysLTs) have been associated with tumor development and progression. Thus, it has been hypothesized that leukotriene receptor antagonists (LTRAs), widely used in the treatment of asthma, could exert a chemopreventive effect due to the modulation of inflammatory pathways. However, the association between LTRAs and cancer risk among asthma patients is still not fully understood. Medline, Scopus, Web of Science, and the Cochrane L…

Survival benefit of particle chemoradiotherapy in locally advanced unresectable pancreatic cancer: a systematic review and meta-analysis.

Therapeutic advances in gastroenterology · 2026 · PMID 42544125

BACKGROUND: The pros and cons of incorporating radiotherapy (RT) into chemotherapy (CT) for locally advanced unresectable pancreatic cancer (LAPC) have been debated for decades. Recently, particle (proton and carbon-ion) therapy has emerged as a new radiotherapy modality. Given the unclear benefits of this approach, we summarized clinical outcomes of LAPC treated with concurrent chemoradiotherapy (CRT) using particle therapy to compare outcomes with current treatments. OBJECTIVES: To evaluate the efficacy and safet…

Vitamin C as an Adjunctive Therapy in Cancer: A Systematic Review and Meta-Analysis of Outcomes in Solid and Hematologic Malignancies.

American journal of clinical oncology · 2026 · PMID 42507830

OBJECTIVES: Vitamin C has gained interest as an adjunctive treatment in oncology due to its antioxidant effects, potential to enhance cancer therapy, and ability to improve quality of life. This systematic review and meta-analysis aimed to assess the therapeutic impact of vitamin C in patients with solid and hematologic malignancies. METHODS: A comprehensive search was conducted in PubMed, Cochrane, Embase, ClinicalTrials.gov, and Google Scholar from inception to August 2025, in accordance with PRISMA guidelines. A…

The molecular mechanism of cuproptosis and research progress in pancreatic diseases.

Annals of medicine · 2026 · PMID 41454639

PURPOSE: Cuproptosis has been proven to be a novel mode of cell death, distinct from other types of cell death such as necrosis, ferroptosis, pyroptosis, and apoptosis. This study aims to systematically review the molecular mechanisms of cuproptosis in recent years and its research progress in pancreatic diseases. METHODS: By searching PubMed and Web of Science databases, 113 key literatures were included for thematic analysis, covering the molecular mechanism of cuproptosis and its role in the occurrence and devel…

Life Course Trajectories of Body Mass Index and Risk of Cancer in Adulthood: Systematic Review and Meta-Analysis.

Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026 · PMID 41787663

OBJECTIVE: This systematic review and meta-analysis aimed to identify common life-course body mass index (BMI) trajectories (childhood/adulthood to adulthood) and their impact on risk of cancer overall and cancer at different sites in adulthood. METHODS: Observational studies were identified that assessed the association of BMI trajectories with cancer risks from databases published in English. The pooled effect sizes were estimated using a random-effects model. FINDINGS: A total of 24 eligible studies were include…

Endoscopic Ultrasound-Guided Radiofrequency Ablation (EUS-RFA): Are We Getting Evidence-Based Results? A Systematic Review According to the Levels of Evidence.

Medicina (Kaunas, Lithuania) · 2026 · PMID 42512924

Background and Objectives: Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is an emerging minimally invasive therapeutic option for pancreatic and selected extra-pancreatic lesions. However, its clinical adoption is limited by heterogeneous indications, non-standardized techniques, and variable quality of evidence. This systematic review assessed the published literature on EUS-RFA and classified available evidence according to the Oxford Centre for Evidence-Based Medicine levels of evidence. Materia…

Preoperative mFOLFIRINOX versus PAXG for stage I-III resectable and borderline resectable pancreatic ductal adenocarcinoma (PACT-21 CASSANDRA): results of the first randomisation analysis of a randomised, open-label, 2 × 2 factorial phase 3 trial.

Lancet (London, England) · 2026 · PMID 41275879

BACKGROUND: Perioperative chemotherapy is a standard option for treatment of patients with resectable and borderline resectable pancreatic ductal adenocarcinoma (PDAC). This study aimed to assess the superiority of PAXG (cisplatin, nab-paclitaxel, capecitabine, and gemcitabine) over mFOLFIRINOX (modified fluorouracil, leucovorin, irinotecan, and oxaliplatin) in this population. METHODS: CASSANDRA is a randomised, open-label, 2 × 2 factorial phase 3 trial, involving 17 Italian academic hospitals. Eligible patients w…

A SUZ12-marked epithelial dedifferentiation state with immune co-expression in pancreatic ductal adenocarcinoma.

Computational biology and chemistry · 2026 · PMID 42361510

BACKGROUND: Polycomb repressive complex 2 (PRC2) silences MHC class I antigen presentation across cancer types, yet the role of its core scaffolding subunit SUZ12 in pancreatic ductal adenocarcinoma (PDAC) immune phenotypes remains poorly characterized. METHODS: We integrated bulk transcriptomics from three cohorts, scRNA-seq (137,976 cells), mouse spatial transcriptomics (5980 spots), Mendelian randomization, colocalization, DepMap CRISPR dependency, tissue microarray immunofluorescence, and siRNA knockdown. RESUL…

Maximal Ablative Irradiation Because of Encasement for Patients With Locally Advanced Pancreatic Cancer: A Nonrandomized Clinical Trial.

JAMA surgery · 2026 · PMID 42525419

IMPORTANCE: The best local therapy approach for patients with locally advanced pancreatic cancer (LAPC) remains undefined. OBJECTIVE: To evaluate hypofractionated ablative radiation therapy (A-RT) followed by evaluation for surgery in patients with LAPC whose cancer remained unresectable after induction chemotherapy. DESIGN, SETTING, AND PARTICIPANTS: This was a phase 2 single-arm nonrandomized clinical trial conducted at the Memorial Sloan Kettering Cancer Center, New York, New York, from June 2018 to April 2024. …

Living With Advanced Pancreatic Cancer: Patients' Experiences of Daily Life.

Psycho-oncology · 2025 · PMID 40903211

BACKGROUND: Pancreatic cancer is often diagnosed in late stages of the disease with only a 10% 5-year survival. The disease is associated with complex symptoms and psychological distress. AIMS: The specific objective of this qualitative study was to explore patients' experiences of what symptoms and distress that had impact on their everyday life. METHODS: We interviewed 31 patients with advanced pancreatic cancer nested within a randomized controlled study, called MISTRAL, about their everyday life using a semi st…

Nutritional Therapy in Pancreatic Cancer: Mechanisms, Clinical Applications, and Future Perspectives.

Nutrition and cancer · 2026 · PMID 42411702

BACKGROUND: Pancreatic cancer is frequently complicated by malnutrition, cancer cachexia, pancreatic exocrine insufficiency (PEI), and sarcopenia, all of which adversely affect treatment tolerance, quality of life, and survival. OBJECTIVE: To review the pathophysiology, assessment, and contemporary nutritional management of pancreatic cancer, with a focus on cachexia, PEI, body composition, and personalized nutritional care. METHODS: This narrative review summarizes evidence from clinical guidelines, randomized tri…

Tumor Microenvironment Gene Engineering with LOAd703 in Patients with Solid Malignancies: LOKON002 Phase I/IIb Clinical Trial.

Clinical cancer research : an official journal of the American Association for Cancer Research · 2026 · PMID 42053989

PURPOSE: Patients with advanced cancer have a poor prognosis and need for novel treatments. LOAd703 is a tumor microenvironment (TME) gene engineering viral vector encoding genes targeting the CD40 and 4-1BB pathways. In this study, tolerability (primary endpoint), response activity, and the capacity to inflame the TME were evaluated. PATIENTS AND METHODS: In an open-label, single-arm phase I/IIb clinical trial (NCT03225989), a maximum of eight intratumoral injections of LOAd703 were administered biweekly, combined…

Higher Daytime Light Exposure Predicts Lower Risk of Gastrointestinal Cancer Incidence and Mortality.

International journal of cancer · 2026 · PMID 42071269

Daytime light exposure is essential for health, primarily by synchronizing tissue and cellular-level clocks with the external light/dark cycle. Insufficient exposure may disrupt circadian alignment and contribute to adverse outcomes, including cancer. Given the high prevalence of gastrointestinal cancer, we conducted a prospective cohort study of 89,069 participants with objectively measured daytime light intensity and duration. Cox proportional hazards models were used to evaluate associations with gastrointestina…

Association between female reproductive factors and new-onset pancreatic cancer risk: a prospective cohort study.

European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) · 2026 · PMID 40889131

The link between female reproductive factors and pancreatic cancer risk is unclear. This study examined these associations in a large prospective cohort and explored potential modification by genetic susceptibility. We analyzed data from 196 563 women in the UK Biobank using multivariable Cox proportional hazards models. Stratified analyses were performed by age, smoking status, BMI, and genetic susceptibility (polygenic risk score, dichotomized as low/high), with multiplicative interaction terms testing effect mod…

Mainstream and fast-track genetic testing in pancreatic cancer patients and its impact on treatment: our experience in a tertiary hospital in Spain.

Familial cancer · 2026 · PMID 42541517

Pancreatic cancer (PC) is a highly lethal malignancy. 4-10% are linked to inherited mutations in genes such as BRCA1/2, PALB2, ATM and mismatch repair (MMR) genes. Germline testing is essential to guide treatment decisions, yet delays remain common. Genetic testing models without pre-test assessment in a Hereditary Cancer Unit (HCU), have emerged as a strategy to improve earlier clinical decision-making. A retrospective, observational and descriptive study was conducted on 223 PC patients (55% male; average age 64 …

Risk-stratified surveillance for individuals in the UK at high risk of developing pancreatic cancer: Outcomes from the European Registry of Hereditary Pancreatic Diseases (EUROPAC).

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 41740463

BACKGROUND: Surveillance of individuals with a familial predisposition to pancreatic ductal adenocarcinoma (PDAC) is likely to increase overall survival. Our objective was to determine the impact of EUROPAC risk-stratification (Family Risk, FR), in such predisposed individuals. METHODS: Observational study of registered asymptomatic individuals undergoing surveillance for PDAC. Individuals without a known pathogenic variant (PV-), ineligible for genetic assessment in the NHS, in whom significant pancreatic lesions …

Pancreatic Cancer Risk Stratification across Diabetes Stages: Development and Internal Validation of a Machine Learning Model.

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026 · PMID 42257579

BACKGROUND: Pancreatic cancer is diagnosed at advanced stages in patients with diabetes. Existing prediction models require complete historical data and focus on new-onset diabetes, limiting applicability. We developed a machine learning model to handle missing data and perform across the diabetes spectrum. METHODS: This is a retrospective cohort study using TriNetX electronic health records. Patients with hemoglobin A1c ≥6.5% were included. Sixty-five clinical variables were extracted at 90-day intervals. An eXtre…

Early-onset Pancreatic Cancer is Associated With Better Survival: A SEER Population-Based Analysis.

Pancreas · 2026 · PMID 42536506

OBJECTIVES: The incidence of early-onset pancreatic cancer is increasing worldwide. This study aimed to evaluate whether survival differences between early and late-onset pancreatic cancer persist after adjustment for tumor characteristics, stage at diagnosis, and treatment, including within stage and treatment-specific subgroups. METHODS: This retrospective SEER cohort study included patients with pancreatic adenocarcinoma diagnosed between 2004 and 2020, with survival follow-up through 2022. Multivariable Cox reg…

Assessing the interplay of operative volume at the hospital and surgeon level for pancreatic cancer.

HPB : the official journal of the International Hepato Pancreato Biliary Association · 2026 · PMID 42542416

BACKGROUND: The current retrospective study aimed to assess the interaction between surgeon-volume and hospital-volume on outcomes after pancreatoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC). METHODS: Patients with PDAC undergoing PD from 2008 to 2023 were identified using the National Cancer Database. Operative volumes of ≥20 cases/year defined high-volume hospitals (HVH) and ≥12 cases/year defined high-volume surgeons (HVS). Those below those thresholds were low-volume surgeons (LVS) and low-volu…

Cause-specific mortality in patients with chronic pancreatitis: a nationwide population-based cohort study.

European journal of internal medicine · 2026 · PMID 41966906

BACKGROUND: Chronic pancreatitis is associated with high mortality, but evidence on the causes of death is limited. We investigated cause-specific mortality, including cancer-related deaths, over a 20-year period following chronic pancreatitis diagnosis. METHODS: Using Danish national health registries, we conducted a nationwide cohort study of incident adult (>18 years) chronic pancreatitis cases from 2002 to 2022. Patients were followed from diagnosis until death or the end of follow-up. Cause-specific mortality …

Construction and validation of a nomogram for overall survival prognosis in patients with advanced (stage III/IV) pancreatic cancer.

Scientific reports · 2026 · PMID 42304037

In order to provide an additional tool for clinical prognosis evaluation, this research attempts to build a nomogram for predicting the survival of patients with advanced (stage Ⅲ/Ⅳ) pancreatic cancer and to preliminary evaluate its predictive impact. Data from 336 patients diagnosed with stage III/IV pancreatic cancer (2018-2025) across two Chinese hospitals were analyzed. Multivariate Cox regression identified independent predictors in the training set, which were used to construct a nomogram estimating 6-, 12-, …

Pancreatic findings in participants in a program of low-dose computed tomography screening for lung cancer.

European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) · 2026 · PMID 41247705

PURPOSE: This study investigates the frequency, progression, and clinical implications of pancreatic findings on chest low-dose computed tomography (LDCT) scans performed for lung cancer screening. METHODS: Analyzing data from the I-ELCAP cohort study (February 2010-June 2023), we identified participants with pancreatic findings on LDCT scans, recording demographics and outcomes. Radiologists reviewed baseline and latest LDCT scans. RESULTS: Out of 9467 participants, 90 (0.9%) had pancreatic findings, mostly male (…

Frailty and low utilization of curative-intent surgical resection in non-metastatic pancreatic cancer.

JNCI cancer spectrum · 2026 · PMID 42536427

INTRODUCTION: Curative-intent treatment for pancreatic ductal adenocarcinoma (PDAC) necessitates major surgery and chemotherapy, yet many patients do not undergo resection. Frailty may contribute to this phenomenon, but its prevalence and association with pancreatectomy in PDAC remains poorly defined. This study describes the distribution of frailty and its association with curative-intent surgery in a nationally representative cohort of patients with non-metastatic PDAC. METHODS: Using SEER-Medicare data (2013-201…

Differentiation of intraductal papillary mucinous neoplasms and pancreatic ductal adenocarcinoma using arterial-phase CT radiomics combined with clinical features.

Frontiers in oncology · 2026 · PMID 42539463

OBJECTIVE: To investigate the value of arterial-phase CT-based radiomics combined with clinical features in differentiating IPMN (Intraductal Papillary Mucinous Neoplasms) from PDAC (Pancreatic Ductal Adenocarcinoma). METHODS: A total of 216 patients with pathologically confirmed IPMN or PDAC were retrospectively enrolled. Clinical data and contrast-enhanced CT images were collected. Patients were divided into a training cohort, a test cohort and the external validation cohort. Univariate and multivariate analyses …

Brain metastases in gastrointestinal cancer patients: a ten-year retrospective study.

Cancer treatment and research communications · 2026 · PMID 42055522

INTRODUCTION: Recent investigations across different populations have drawn attention to the delayed presentation of GI cancers as BMs. Accordingly, this study aimed to evaluate the incidence of BMs in GI cancers over the past decade at one of the primary national referral centers for such patients. METHODS: This descriptive, cross-sectional study was conducted in 2025 at Alzahra Hospital. The study population comprised all patients with GI cancers who visited the hospital between 2015 and 2025 and had complete med…

Prognostic Value of Digitally Quantified CDX2 Expression in Pancreatic Ductal Adenocarcinoma Without Intestinal Differentiation.

International journal of surgical pathology · 2026 · PMID 41944427

BackgroundCDX2 is a transcription factor critical for intestinal development and differentiation. While its prognostic value is established in colorectal cancer, its significance in pancreatic ductal adenocarcinoma (PDAC) remains unclear. Given the overlap of intestinal-type features in intraductal papillary mucinous neoplasms (IPMNs), clarifying the role of CDX2 in PDAC and IPMN may provide insights into tumor biology and prognostic markers.MethodsWe retrospectively analyzed 35 PDAC and 42 IPMN-associated carcinom…

Endoscopic Ultrasound-Guided Radiofrequency Ablation (EUS-RFA): Are We Getting Evidence-Based Results? A Systematic Review According to the Levels of Evidence.

Medicina (Kaunas, Lithuania) · 2026 · PMID 42512924

Background and Objectives: Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is an emerging minimally invasive therapeutic option for pancreatic and selected extra-pancreatic lesions. However, its clinical adoption is limited by heterogeneous indications, non-standardized techniques, and variable quality of evidence. This systematic review assessed the published literature on EUS-RFA and classified available evidence according to the Oxford Centre for Evidence-Based Medicine levels of evidence. Materia…

Research advances on tumor-associated macrophages in pancreatic cancer.

Biochemistry and biophysics reports · 2026 · PMID 42519576

Pancreatic cancer, as a highly malignant tumor, is often regarded as one of the cancers with the poorest prognosis due to its insidious early symptoms, aggressive nature, and extremely poor clinical outcomes. Within the immune microenvironment of pancreatic cancer, tumor-associated macrophages (TAMs) constitute the predominant and central type of immune cell. They play a crucial regulatory role in key processes such as tumor initiation, progression, angiogenesis, and immune evasion. Furthermore, TAMs are deeply inv…

The efficacy of brachytherapy with radioactive 125I therapy in pancreatic cancer.

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · 2026 · PMID 42420074

OBJECTIVE: To evaluate the therapeutic efficacy and prognosis of 125I brachytherapy in advanced pancreatic cancer and to investigate its effects on the malignant phenotype of pancreatic cancer in vitro and in vivo. METHODS: Forty patients with advanced, unresectable pancreatic cancer were enrolled, including 18 in the chemotherapy group and 22 in the 125I combined with the chemotherapy group. The present study represents a non-randomized, retrospective cohort study with patients allocated to treatment groups based …

REG4 serves as a prognostic biomarker for pancreatic cancer with long-standing diabetes mellitus by modulating chemoresistance.

Translational oncology · 2026 · PMID 42398462

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) in patients with diabetes mellitus (DM) represents a clinically heterogeneous subgroup, yet biomarkers that reflect diabetes-associated tumor biology and chemotherapy response remain limited. In particular, the influence of diabetes duration on treatment resistance in PDAC is poorly understood. METHODS: We performed an integrated translational analysis combining reanalysis of public single-cell RNA sequencing (scRNA-seq) datasets, clinical serum biomarker profilin…

Depleting Ly6G Positive Myeloid Cells Reduces Pancreatic Cancer-Induced Skeletal Muscle Atrophy.

Cells · 2022 · PMID 35741022

Immune cells can mount desirable anti-cancer immunity. However, some immune cells can support cancer disease progression. The presence of cancer can lead to production of immature myeloid cells from the bone marrow known as myeloid-derived suppressor cells (MDSCs). The immunosuppressive and pro-tumorigenic effects of MDSCs are well understood. Whether MDSCs are involved in promoting cancer cachexia is not well understood. We orthotopically injected the pancreas of mice with KPC cells or PBS. One group of tumor-bear…

Renin-angiotensin-aldosterone system inhibitors and risk of pancreatic cancer in older adults: A target trial emulation.

International journal of cancer · 2026 · PMID 41872700

Pancreatic ductal adenocarcinoma (PDAC) is a major cause of cancer-related mortality worldwide. Preclinical studies suggest that the renin-angiotensin-aldosterone system (RAAS) inhibitors may help prevent PDAC by promoting acinar ductal metaplasia reversal, as the RAAS pathway is most inhibited during this process. Our study aims to examine the association between RAAS inhibitor use and the risk of PDAC compared with calcium channel blockers (CCB). Leveraging the target trial emulation framework, we used US Medicar…

Expanded GEP-NET organoid culture for personalized therapy evaluation.

Science advances · 2026 · PMID 42497252

Gastro-entero-pancreatic neuroendocrine tumors (GEP-NETs) are a rare subset of cancers with increasing incidence. Due to their slow growth and lack of targetable mutations, the identification of effective treatments remains limited. One reason behind this stagnation is the lack of applicable, accurate study models. One solution is patient tumor organoids (PTOs) that maintain tumor characteristics and can scale for high throughput assays. In this study, PTOs were generated from 35 tumors of pancreatic, small intesti…

Comparative evaluation of chemotherapy and CAR-T cell therapy in genetically engineered self-sustaining primary pancreatic cancer organoids.

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · 2026 · PMID 42532746

BACKGROUND: Broader research and translational use of patient-derived organoids (PDOs) in pancreatic ductal adenocarcinoma (PDAC) remain constrained by complex and costly culture requirements. Here, we developed a conditional transgenic strategy to generate self-sustaining primary PDAC organoids and explored its feasibility for therapeutic evaluation. METHODS: We established a proof-of-concept PDAC organoid biobank (n = 10). Using a doxycycline-inducible lentiviral Tet-On system, we engineered organoids to express …

FOXM1-Driven CKS1B Upregulation Promotes Pancreatic Cancer Progression and Therapeutic Resistance.

International journal of biological sciences · 2025 · PMID 39897042

Pancreatic ductal adenocarcinoma (PDAC) remains a highly lethal malignancy with limited treatment options. Investigating novel therapeutic targets and understanding mechanisms of chemoresistance are crucial for improving patient outcomes. This study investigated the role of CKS1B in PDAC carcinogenesis, stemness and chemoresistance, and explores the underlying mechanisms driving its upregulation. The findings may provide novel therapeutic insights and potential strategies for the treatment of PDAC. Methods: CKS1B e…

Reversal of KRAS G12D inhibitor resistance by nimotuzumab via MEK/ERK-mediated unfolded protein response in pancreatic cancer.

Cancer letters · 2026 · PMID 42303056

Pancreatic ductal adenocarcinoma (PDAC) is highly aggressive, with KRAS mutations, particularly KRAS G12D, present in the majority of cases. While development of KRAS G12D inhibitors is rapid, acquired resistance remains a major clinical challenge. Therefore, in this study, we aimed to evaluate the efficacy of novel KRAS G12D inhibitor HRS-4642, investigate its potential resistance mechanisms, and overcome resistance through combination therapy. The results demonstrated that although HRS-4642 showed potent and sele…

Design and synthesis of mitochondria-targeted betulinic acid derivatives with antipancreatic cancer activity via ROS-mediated apoptosis and ferroptosis.

Bioorganic chemistry · 2026 · PMID 42081868

BACKGROUND: Pancreatic cancer is a highly lethal malignancy that is frequently accompanied by drug resistance. Betulinic acid (BA) has therapeutic potential; its clinical utility is hampered by poor solubility and a lack of organelle-specific targeting. Given the functional abnormalities of tumor mitochondria, mitochondria-targeted interventions may enhance therapeutic efficacy while reducing systemic toxicity. METHODS: Using BA as the parent scaffold, we designed and synthesized 30 mitochondria-targeted BA derivat…

Tumor Treating Fields (TTFields) potentiate cisplatin efficacy and remodel the transcriptional landscape in preclinical models of pancreatic ductal adenocarcinoma.

Cancer letters · 2026 · PMID 42288239

Pancreatic ductal adenocarcinoma (PDAC) is among the deadliest cancers, with a 5-year survival rate of 3.2% in metastatic cases. Cisplatin, a DNA-damaging agent, offers minimal benefit due to PDAC's altered DNA repair and protective stroma. Tumor Treating Fields (TTFields), low intensity alternating electric fields that disrupt mitosis, have shown promise in other solid tumors. We investigated whether TTFields enhance cisplatin efficacy in PDAC and explored the underlying biology. PDAC cell lines were treated with …

IL-12 augments adoptive cell therapy by reshaping CD8+ T dynamics and broadening antitumor immunity.

Cancer letters · 2026 · PMID 42097493

Adoptive cell therapy (ACT) against solid tumors is constrained by tumor heterogeneity, immunosuppressive microenvironments, and insufficient T cell potency and persistence. Although IL-12 has long been recognized as a potent enhancer of T-cell immunity, its clinical application has been hindered by systemic toxicity and the lack of a strategy to harness its benefits without chronic exposure. Here, we show that ex vivo IL-12 preconditioning programs tumor-specific T cells with increased antigen sensitivity, yieldin…

Goosecoid facilitates the metastasis of pancreatic adenocarcinoma by enhancing EMT and stemness via regulating TGF-β/SMAD2/3 signaling.

Cell cycle (Georgetown, Tex.) · 2026 · PMID 41532321

Pancreatic adenocarcinoma (PAAD) is a highly aggressive malignant tumor of the gastrointestinal tract. Goosecoid (GSC), translated from a homeobox gene, is a protein participating in metastasis of assorted tumors. This study explores the role of GSC implicated in tumor metastasis, in PAAD progression. GSC expression in PAAD tissues and cells were tested by quantitative polymerase chain reaction (PCR) and western blot. GSC mRNA and protein expressions were elevated in PAAD tissues and cells. The impacts of GSC deple…

Pan-cancer analysis reveals the prognostic relevance of NUP54 and its association with HIF-1α-related glycolytic phenotypes in lung adenocarcinoma.

Cellular signalling · 2026 · PMID 42349706

The role of the nuclear pore protein NUP54 in tumorigenesis and progression remains unclear. By integrating multiomics data from TCGA, GTEx, CPTAC, and other sources, in this study, the first pan-cancer landscape of NUP54 was systematically delineated: its mRNA and protein expression levels are significantly upregulated in most types of cancer, including lung adenocarcinoma, hepatocellular carcinoma, and gastric cancer. It has a high diagnostic value across several types of cancer, including cholangiocarcinoma and …

Discovery of pyrazole derivative IHMT-140 as a pancreatic cancer therapeutic agent via dual mechanisms DDR1 inhibition and methuosis induction.

Journal of advanced research · 2026 · PMID 42521155

INTRODUCTION: Pancreatic cancer continues to be among the most lethal malignancies. The distinct tumor microenvironment (TME) not only facilitates tumor cell proliferation, invasion, and metastasis but also establishes a formidable barrier to the diffusion of chemotherapeutic agents and immunotherapies. Consequently, it is imperative to identify novel compounds that target the tumor microenvironment (TME). OBJECTIVES: This study aims to identify a small molecule as a therapeutic agent for pancreatic cancer through …

From veterinary antibiotic to cancer therapy: revisiting anticancer potential of Monensin.

Molecular biology reports · 2026 · PMID 42530725

Monensin, a polyether ionophore widely used in veterinary medicine, has recently emerged as a multimodal anticancer candidate. This review provides a comprehensive overview of preclinical studies showing that monensin exerts selective cytotoxic and anti-progression effects across a wide range of malignancies. Its activity spans breast cancer to leukemia, reflecting both versatility and significant therapeutic potential. In breast cancer, monensin reduces proliferation, induces apoptosis, and enhances chemosensitivi…

Study on Synergistic Treatment of Pancreatic Cancer by Multiple Small Interfering Ribonucleic Acid Lipid Nanoparticles of Disk Domain Receptor 1, Transforming Growth Factor β1, Tumor-Associated Calcium Signal Transduction Protein 2, and Polyligand Proteoglycan 1.

Pharmaceutics · 2026 · PMID 42514856

Background/Objective: This study aimed to use multiple disk domain receptor 1 (DDR1), transforming growth factor β1 (TGFβ-1), tumor-associated calcium signal transduction protein 2 (TACSTD2), and polyligand proteoglycan 1 (SDC1) siRNA to treat pancreatic cancer with the goals of high specificity, significant therapeutic efficacy, and relatively low toxicity. Methods: (1) A microfluidic method was used to prepare siRNA-LNPs with different formulations. (2) Quantitative PCR (qPCR) and Western blot assays were used to…

Targeted Immunoliposomal Delivery of a 5-Fluorouracil Analog in EGFR-Expressing Pancreatic Cancer Models.

Technology in cancer research & treatment · 2026 · PMID 42531480

IntroductionDysregulated epidermal growth factor receptor (EGFR) signaling is a key mechanism driving cancer progression and metastasis. Owing to its frequent overexpression in pancreatic cancer (PCa), EGFR has become a desirable molecular target for targeted therapies. XYZ-I-73 (N-(5-fluoro-2-oxo-1-(tetrahydrofuran-2-yl)-1,2-dihydropyrimidin-4-yl) dodecanamide), a structural analog of 5-fluorouracil (5-FU), has been previously synthesized and shown to exhibit cytotoxicity against PCa cells.MethodsXYZ-I-73 was entr…

Translational PK-PD/TD modeling of antitumor effects and peripheral neuropathy in gemcitabine and nab-paclitaxel chemotherapy from xenograft mice to patients for optimal dose and schedule.

Cancer chemotherapy and pharmacology · 2024 · PMID 38117301

PURPOSE: Gemcitabine and nab-paclitaxel (GnP) treatment, the standard first-line chemotherapy for unresectable pancreatic cancer, often causes peripheral neuropathy (PN). To develop alternative dosing strategies to avoid severe PN, understanding the relationship between pharmacokinetics (PK) and pharmacodynamics/toxicodynamics (PD/TD) is necessary. We established a PK-PD/TD model of GnP treatment to develop an optimal dose schedule. METHODS: A mouse xenograft model of human pancreatic cancer was generated to measur…

Smad2 Cooperating with TGIF2 Contributes to EMT and Cancer Stem Cells Properties in Pancreatic Cancer via Co-Targeting SOX2.

International journal of biological sciences · 2025 · PMID 39781447

The underlying mechanisms between cancer stem cells (CSC) and epithelial-mesenchymal transition (EMT) in pancreatic cancer (PC) remain unclear. In this study, we identified TGIF2 as a target gene of CSC using sncRNA and machine learning. TGIF2 is closely related to the expression of SOX2, EGFR, and E-cadherin, indicating poor prognosis. Mechanistically, TGIF2 promoted the EMT phenotype and CSC properties following the activation of SOX2, Slug, CD44, and ERGF/MAPK signaling, which were rescued by SOX2 silencing. TGI…

SMAD4 and KRAS Status Shapes Cancer Cell-Stromal Cross-Talk and Therapeutic Response in Pancreatic Cancer.

Cancer research · 2025 · PMID 39841099

Pancreatic ductal adenocarcinoma (PDAC) contains an extensive stroma that modulates response to therapy, contributing to the dismal prognosis associated with this cancer. Evidence suggests that PDAC stromal composition is shaped by mutations within malignant cells, but most previous work has focused on preclinical models driven by KrasG12D and mutant Trp53. Elucidation of the contribution of additional known oncogenic drivers, including KrasG12V mutation and Smad4 loss, is needed to increase the understanding of ma…

Panobinostat-Loaded Albumin Nanoparticles for the Treatment of Pancreatic Cancer.

Journal of drug delivery science and technology · 2025 · PMID 40859982

Panobinostat is a highly active and potent non-selective histone deacetylase inhibitor (HDACi) that demonstrates significant anticancer activity against various cancers, including pancreatic cancer. However, like other HDAC inhibitors, its anticancer efficacy is often limited due to factors such as hydrophobicity, non-specificity to tumor cells, and poor pharmacokinetics. To overcome these limitations, encapsulating panobinostat in nanocarriers can enhance controlled drug release and increase cellular uptake, there…

Apoptosis induction and migration suppression through regulation of IGF-1R/FoxO signaling pathways in Panc1 pancreatic cancer cells by hAMSCs secretome: An in vitro cell-based therapy.

Cancer treatment and research communications · 2026 · PMID 41990634

Pancreatic cancer often referred to as the "king of cancers," is a disease with no symptoms and lacks effective therapy. Current treatment options for pancreatic cancer have not been successful, highlighting the need for new therapeutic avenues with minimal side effects and improved effectiveness. In recent years, new cell-based therapies using stem cells or their derivatives have shown promise in treating various diseases, including cancer. Here, we aimed to explore the impact of the secretome of human amniotic me…

CREB-SEC61G feedback loop sustains enhanced autophagy and boosts proliferation in PDAC.

Cell death & disease · 2026 · PMID 42215441

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal malignancies, with rising incidence and mortality rates, in which autophagy plays a pivotal role in promoting tumor survival. Although SEC61G has been reported to be associated with poor outcomes in patients with PDAC, its underlying mechanism remains largely unclear. In the present study, we found that SEC61G was overexpressed in PDAC and correlated with an unfavorable patient prognosis. Further experiments demonstrated the pro-proliferation efficac…

[177Lu]Lu-DOTATATE PRRT and CAPTEM chemotherapy for pancreas and small bowel neuroendocrine tumours: The AGITG CONTROL NETS Multi-centre randomized trial.

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 42142431

BACKGROUND/AIM: To evaluate the efficacy of [177Lu]Lu-DOTATATE peptide receptor radionuclide therapy (PRRT) plus capecitabine and temozolomide (CAPTEM) in participants(pts) with progressive WHO Grade 1-2 neuroendocrine tumours: pancreas(pNETs) and small bowel(SBNETs). METHODS: Non-comparative randomized open label parallel group phase II trial, 2:1 randomization to PRRT/CAPTEM (experimental arm) vs PRRT (SBNETs control) and CAPTEM (pNETs control). PRRT/CAPTEM: 7.8 GBq [177Lu]Lu-DOTATATE i.v. Day 10, 8 weekly x 4, c…

Second-line liposomal irinotecan plus S-1 vs. liposomal irinotecan plus 5-fluorouracil in metastatic pancreatic cancer: The phase I/II randomized NAPAN trial.

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 41921365

BACKGROUND: This study aimed to determine the optimal second-line treatment strategy in patients with metastatic pancreatic cancer, hypothesizing that liposomal irinotecan (nal-IRI) combined with S-1 would be superior to nal-IRI with 5-fluorouracil (5-FU)/leucovorin (LV). METHODS: This was an international, multi-center, open-label, randomized phase I/II superiority trial. Patients with pancreatic adenocarcinoma, previously treated with gemcitabine-based treatment, were enrolled. Patients were randomly allocated to…

Modified FOLFIRINOX with or Without Stereotactic Body Radiation in Locally Advanced Unresectable Pancreatic Cancer (SABER): A Randomized Open-Label Phase 2 Trial.

Annals of surgical oncology · 2026 · PMID 42098550

BACKGROUND: Prospective data on stereotactic body radiation therapy (SBRT) combined with modified 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin (mFOLFIRINOX) in patients with locally advanced unresectable pancreatic adenocarcinoma (PDAC) are limited. PATIENTS AND METHODS: The SABER trial was an open-label, randomized, phase 2 study. Patients with locally advanced, unresectable PDAC were eligible if they were suitable for SBRT with adherence to organ-at-risk constraints. Participants were randomized (1:1) …

[177Lu]Lu-dota-tate versus sunitinib in patients with metastatic progressive neuroendocrine tumours of the pancreas (OCLURANDOM): a randomised, controlled, phase 2 trial.

The Lancet. Oncology · 2026 · PMID 42225102

BACKGROUND: To our knowledge, no randomised trial with peptide receptor radionuclide therapy has been done in patients with metastatic pancreatic neuroendocrine tumours. We aimed to evaluate the antitumour activity and safety of [177Lu]Lu-dota-tate in this setting. METHODS: OCLURANDOM is a randomised, open-label, non-comparative, phase 2 trial conducted in ten academic centres in France. Patients aged 18 years and older with pretreated, progressive, somatostatin receptor-positive, metastatic pancreatic neuroendocri…

Serplulimab combined with gemcitabine, nab-paclitaxel, and stereotactic body radiotherapy versus gemcitabine and nab-paclitaxel as first-line treatment for recurrent or metastatic pancreatic ductal adenocarcinoma: a randomized, open-label, multicenter, phase III clinical trial (WGOG-PAN 006/ICSBR-2).

Frontiers in immunology · 2026 · PMID 42212134

BACKGROUND: Pancreatic ductal adenocarcinoma remains a malignancy with a dismal prognosis, characterized by a median overall survival of less than one year in the metastatic setting despite standard-of-care chemotherapy regimens like gemcitabine plus nab-paclitaxel. The PDAC tumor microenvironment is notoriously immunosuppressive, rendering single-agent immune checkpoint inhibitors largely ineffective. Stereotactic Body Radiotherapy has emerged as a potential strategy to induce immunogenic cell death and remodel th…

Metastatic tropism of molecularly defined clear-cell renal cell carcinoma clusters.

The Journal of clinical investigation · 2026 · PMID 42138077

BACKGROUNDThe relationship between molecular subgroups in clear-cell renal cell carcinoma (ccRCC) and metastatic tropism is poorly understood.METHODSWe analyzed over 5,000 metastatic sites from 305 treatment-naive ccRCC patients in the IMmotion150 phase II clinical trial, where patients were randomized to atezolizumab, atezolizumab/bevacizumab, or sunitinib.RESULTSAngiogenic tumors (clusters 1 and 2) had a higher rate of pancreatic (21% vs. 6.9%; P = 0.002) and lower absolute number of lymph node (2.5 vs. 4.2; P = …

Fibroblast Activation Protein-Targeted Radiopharmaceutical Therapy Using 177Lu-, 90Y-, and 225Ac-Labeled 3BP-3940: First Experience in 21 Different Advanced Malignancies.

Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2026 · PMID 42225357

Fibroblast activation protein (FAP) is an attractive target for molecular precision imaging and therapy, given its specific tumor expression across various cancer types. We report first-in-human results using a FAP-targeted cyclic peptide, 3BP-3940, labeled with 177Lu, 90Y, and 225Ac for FAP-targeted radiopharmaceutical therapy (FRT) in patients with end-stage cancer. Methods: Eighty-eight patients with 21 distinct advanced metastatic solid tumor types received 227 cycles of 177Lu-, 90Y-, 225Ac-labeled 3BP-3940, ei…

Nab-paclitaxel plus S-1 induction chemotherapy for patients with locally advanced pancreatic cancer: a multicenter, open-label phase 2 study.

Signal transduction and targeted therapy · 2026 · PMID 42324245

Locally advanced pancreatic cancer (LAPC) is associated with a poor prognosis and limited therapeutic options. This study aimed to evaluate the efficacy and safety of nab-paclitaxel plus S-1 (SnP) as a first-line treatment in patients with previously untreated LAPC. In this multicenter, single-arm phase 2 trial conducted across four centers in China, eligible patients received up to eight cycles of nab-paclitaxel combined with S-1, followed by investigator-selected continuation strategies in the absence of disease …

Daraxonrasib in Previously Treated Advanced RAS-Mutated Pancreatic Cancer.

The New England journal of medicine · 2026 · PMID 42090791

BACKGROUND: Current therapies for patients with pancreatic ductal adenocarcinoma (PDAC) provide modest benefit. Activating RAS mutations occur in more than 90% of PDAC tumors. Daraxonrasib (RMC-6236) is an oral RAS(ON) multiselective inhibitor that targets guanosine triphosphate-bound mutant and wild-type RAS. METHODS: In this phase 1-2 study, we evaluated daraxonrasib in patients with advanced solid tumors with activating RAS mutations. Patients received 10 to 400 mg of daraxonrasib orally once daily; 300 mg was s…

Adjuvant stereotactic pancreatic radiotherapy (SPARTA trial): interim safety analysis of an ongoing phase II single center prospective study.

Radiation oncology (London, England) · 2026 · PMID 42129843

AIMS: This interim safety/toxicity analysis aims to assess toxicity of adjuvant stereotactic body radiation therapy (SBRT) after surgery of pancreatic cancer (PC) with high risk features across an ongoing prospective phase II trial, allowing better integration of chemotherapy and surgery. METHODS: The study started in 2021 and this paper represents an interim safety analysis. Enrollment will last 36 months, followed by 12 months of follow-up for a duration of 4 years and 50 patients. Inclusion criteria are: pT1-T4 …

Niraparib in pancreatic cancer with germline or somatic DNA damage repair (DDR) gene alterations (BRCA and beyond): a phase II study (NIRA-PANC).

The oncologist · 2026 · PMID 42249558

BACKGROUND: Globally, pancreatic cancer is one of the leading causes of cancer-related mortality. Although FDA-approved chemotherapy regimens are available, rapid deterioration is often observed after first-line treatment. The PARP inhibitor niraparib may offer a therapeutic benefit in patients with advanced pancreatic cancer, necessitating thorough investigation. PATIENTS AND METHODS: This was an open-label, single-arm, phase II trial involving 37 patients with metastatic or unresectable pancreatic cancer with DNA…

Phase 2 dose-expansion trial of OBI-3424, a DNA-alkylating prodrug, in patients with advanced solid tumors expressing AKR1C3.

The oncologist · 2026 · PMID 42390142

BACKGROUND: OBI-3424 is an investigational small-molecule prodrug. In a dose-escalation trial, the OBI-3424 recommended phase 2 dose (RP2D) was 12 mg/m2 administered every 21 days. In this phase 2 dose-expansion trial, we evaluated the safety and efficacy of OBI-3424 in pancreatic adenocarcinoma and other solid tumor types ("basket" cohort). METHODS: Patients with advanced solid tumors and an AKR1C3 IHC H-score of ≥ 100 were treated at the RP2D of OBI-3424. Tumor response, progression-free survival (PFS), overall s…

Tumor Microenvironment Gene Engineering with LOAd703 in Patients with Solid Malignancies: LOKON002 Phase I/IIb Clinical Trial.

Clinical cancer research : an official journal of the American Association for Cancer Research · 2026 · PMID 42053989

PURPOSE: Patients with advanced cancer have a poor prognosis and need for novel treatments. LOAd703 is a tumor microenvironment (TME) gene engineering viral vector encoding genes targeting the CD40 and 4-1BB pathways. In this study, tolerability (primary endpoint), response activity, and the capacity to inflame the TME were evaluated. PATIENTS AND METHODS: In an open-label, single-arm phase I/IIb clinical trial (NCT03225989), a maximum of eight intratumoral injections of LOAd703 were administered biweekly, combined…

A phase II clinical trial of albumin-bound paclitaxel, cisplatin, gemcitabine (NABPLAGEM), and paricalcitol as neoadjuvant therapy in pancreatic cancer.

The oncologist · 2026 · PMID 42268676

BACKGROUND: For patients with untreated pancreatic ductal adenocarcinoma (PDAC), chemotherapy before surgery ("neoadjuvant therapy") has shown benefit in reducing recurrence and prolonging survival. Targeting the vitamin D receptor (VDR) with analogs such as paricalcitol may improve chemotherapy effectiveness. This study evaluated the efficacy and safety of neoadjuvant albumin-bound paclitaxel (nab-paclitaxel) plus cisplatin plus gemcitabine (NABPLAGEM) plus paricalcitol (NCT03138720). METHODS: Participants were ≥1…

High-Intensity Interval Training Boosts Immune Cells in Advanced Cancer Patients and Healthy Controls: Implications for Cancer Care.

Cancer medicine · 2026 · PMID 42233178

BACKGROUND: Regular exercise improves quality of life (QoL) and reduces fatigue in advanced cancer patients (ACP), but acute immune responses are underexplored. This study investigated the effects of a single high-intensity interval training (HIIT) session on natural killer (NK) cells and circulating innate lymphoid cells (cILCs) in ACP. METHODS: An ACP group undergoing chemotherapy (PG, n = 20, 59.8 ± 10.3 years, 70% pancreatic cancer) was compared with age-matched healthy controls (HG, n = 19, 60.7 ± 10.6 years).…

Safety and efficacy of fecal microbiota transplantation in solid cancers resistant to immune checkpoint inhibitors: results of the MITRIC trial.

Journal for immunotherapy of cancer · 2026 · PMID 42476727

BACKGROUND: Fecal microbiota transplantation (FMT) has shown promise in overcoming resistance to immune checkpoint inhibitors (ICIs) in early-phase cancer trials. We investigated the safety, feasibility and efficacy of FMT from ICI responders to patients with advanced cancers progressing on ICIs. METHODS: This was a single-arm phase IIa basket trial (MITRIC; NCT05286294) including patients with ICI-refractory cancer. Long-term ICI responders were used as FMT donors. Patients received FMTs in combination with ICIs; …

Erdafitinib in Patients With Advanced Solid Tumors With FGFR Alterations (RAGNAR): Results of Tumor-Specific Analyses and Secondary Cohorts.

JCO precision oncology · 2026 · PMID 42456086

PURPOSE: Erdafitinib, a pan-fibroblast growth factor receptor (FGFR) tyrosine kinase inhibitor, is approved for second-line treatment of locally advanced or metastatic urothelial carcinoma with susceptible FGFR3 alterations. Primary histology-agnostic analysis from the phase II RAGNAR study (ClinicalTrials.gov identifier: NCT04083976) indicated a clinical benefit with erdafitinib in Broad Panel Cohort (BPC) patients. We present tumor-specific updated efficacy and safety results from the BPC and tumor-agnostic findi…

A New CA19-9 Cutoff Value Identifies Lewis Antigen Status and Refines Prognostic Stratification in PDAC.

Clinical cancer research : an official journal of the American Association for Cancer Research · 2026 · PMID 42162970

PURPOSE: Carbohydrate antigen 19-9 (CA19-9) has limited utility in the ∼10% of patients with pancreatic ductal adenocarcinoma (PDAC) who are Lewis-negative CA19-9 "nonproducers" (FUT3-null). This study aims to define the prognosis of FUT3-null PDAC and establish a CA19-9 cutoff that can help identify this subgroup in clinical practice. EXPERIMENTAL DESIGN: Germline whole-exome sequencing was performed in a multicenter cohort of 615 patients with PDAC to determine FUT2/FUT3 genotypes. Receiver operating characterist…

T cell receptor gene therapy targeting KRAS G12V for advanced pancreatic cancer in a single-arm phase 1/2 clinical trial.

Molecular therapy : the journal of the American Society of Gene Therapy · 2026 · PMID 41814655

Adoptive T cell transfer targeting KRAS G12D can induce tumor regression in advanced epithelial cancers. The safety, efficacy of T cell receptor (TCR)-T cells targeting KRAS G12V, and potential benefit of repeat infusions remain unknown. In a single-arm phase 1/2 clinical trial (NCT04146298), we treated five patients with recurrent pancreatic cancer using adoptive transfer of autologous T cells engineered to express an HLA-A∗11:01-restricted KRAS G12V8-16-specific TCR. Three patients received multiple infusions. Pr…

Prediction of cancer-associated thrombosis by machine learning: results from the Vienna Cancer and Thrombosis Study.

ESMO open · 2026 · PMID 42202491

BACKGROUND: Improved risk prediction of cancer-associated venous thromboembolism (VTE) remains an unmet clinical need. We aimed to apply machine learning for the prediction of cancer-associated VTE. PATIENTS AND METHODS: Data from the Vienna Cancer and Thrombosis Study (Vienna-CATS), a prospective cohort study that included patients with cancer from 2003-2019, were used. Patient characteristics and laboratory measurements (including various routine and experimental laboratory assays) were used to train and validate…

Netrin1 blockade alleviates resistance to chemotherapy in pancreatic cancer.

Nature · 2026 · PMID 42020751

Netrin1, a developmental cue, is a master regulator of tumour epithelial-to-mesenchymal transition (EMT)1, a mechanism that is known to drive resistance to chemotherapy2. A netrin1 antibody (NP137)3 has been shown to inhibit tumour EMT in preclinical1 and clinical4 settings. In animal models of pancreatic cancer, netrin1 and its receptor neogenin have been shown to promote tumour progression5, EMT5 and metastasis6. Here we report the results of a phase 1b study that assesses the combination of NP137 with modified F…

Targeting of MEK and Autophagy in Pancreatic Adenocarcinoma and Analysis of Treatment Sensitivity in Preclinical and Clinical Models: MEKiAUTO.

JCO precision oncology · 2026 · PMID 42284543

PURPOSE: Combined mitogen-activated protein kinase kinase (MEK) and autophagy inhibition has shown antitumor efficacy in preclinical pancreatic ductal adenocarcinoma (PDAC) models. We evaluated this therapeutic strategy in the autochthonous K-rasLSL.G12D/+; Trp53R172H/+; Pdx-1-Cre (KPC) mouse model and in the MEKiAUTO phase I trial of patients with metastatic KRAS-mutant PDAC, with or without anti-PD-L1 antibody atezolizumab. METHODS: Short-term intervention studies in KPC mice and a phase I clinical trial based on…

The SHERPA trial: A phase I study combining SHP2 inhibitor RMC-4630 and ERK inhibitor LY3214996 in patients with KRAS-mutant pancreatic, non-small cell lung and colorectal cancer.

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 42114409

INTRODUCTION: PDAC has high mortality rates and limited treatment options. KRAS mutations are present in > 90% of patients with PDAC, causing constitutive activation of the MAPK pathway. Preclinical studies demonstrated synergistic antitumor activity in in vivo and in vitro KRAS-mutant PDAC models by combining SHP2 and ERK inhibition. Therefore, the safety of combining SHP2 inhibitor RMC-4630 and ERK inhibitor LY3214996 was evaluated in this phase I trial. METHODS: The aim was defining the recommended phase 2 dose …

Phase I study of the anti-TIGIT antibody tiragolumab in combination with atezolizumab in Japanese patients with advanced or metastatic solid tumors.

Cancer chemotherapy and pharmacology · 2024 · PMID 38206370

PURPOSE: Tiragolumab is a monoclonal antibody that binds to the inhibitory immune checkpoint TIGIT (T-cell immunoreceptor with Ig and ITIM domains). In early phase clinical trials, tiragolumab in combination with the programmed death-ligand 1-inhibitor atezolizumab was well tolerated and has demonstrated preliminary anti-tumor activity in patients with advanced/metastatic solid tumors. We report the results of a phase I study of tiragolumab plus atezolizumab in Japanese patients (jRCT2080224926). METHODS: Japanese …

Distinct Malignant Cell States and Myeloid Glutamate Signaling Associated with Aggressive Pancreatic Neuroendocrine Tumors.

Clinical cancer research : an official journal of the American Association for Cancer Research · 2026 · PMID 41849229

PURPOSE: Pancreatic neuroendocrine tumors (PNET) are rare malignancies of the endocrine pancreas with diverse clinical outcomes. Whereas some PNETs are indolent, others are aggressive and metastasize quickly. However, clinically relevant molecular stratification for PNET to predict outcomes and guide therapeutic decision-making is limited. Thus, there is an urgent need to understand the molecular heterogeneity of PNETs to refine prognostication and discover novel therapeutic vulnerabilities. EXPERIMENTAL DESIGN: We…

pRECIST: Guidelines for Response Criteria for Use in Trials Testing Therapeutics in Pancreatic Cancer.

Pancreas · 2026 · PMID 41941588

IMPORTANCE: Pancreatic tumor response to treatment remains challenging and varies greatly. In order to establish a standardized approach to measuring and evaluating pancreatic tumor metabolic activity (MA), a consensus guideline called Pancreatic RECIST (pRECIST) was developed. This guideline is based on modified Response Evaluation Criteria in Solid Tumors (RECIST version 1.1), incorporating concurrent CT/PET scan quantitative assessments. OBJECTIVE: The aims were to ensure consistent design, data collection, and …

Association of dietary intake and serum levels of unsaturated fatty acids and risk of pancreatic cancer: A GRADE-assessed systematic review and dose-response meta-analysis of prospective cohort studies.

Cancer epidemiology · 2026 · PMID 42235418

Lifestyle and dietary factors contribute to about one-third of cancer deaths. The fatty acid composition in diets may be related to pancreatic cancer. A prior meta-analysis examining the connection between mono- and polyunsaturated fatty acid intake and pancreatic cancer risk has not investigated the dose-response relationship. This systematic review and dose-response meta-analysis aims to explore the association between dietary intake and serum levels of unsaturated fatty acids and the risk of pancreatic cancer in…

Reverse-Bevel (ProCore) EUS-Guided Fine-Needle Biopsy for Solid Pancreatic Mass Lesions: a GRADE-Assessed Systematic Review and Meta-Analysis of Prospective Randomized Trials.

Journal of gastrointestinal cancer · 2026 · PMID 42406286

BACKGROUND AND AIMS: Endoscopic ultrasound-guided tissue acquisition is used to diagnose pancreatic mass lesions, but optimal needle selection remains uncertain. Reverse bevel ProCore fine needle biopsy (FNB) needles aim to enhance histologic procurement and reduce sampling burden; randomized evidence versus standard fine needle aspiration (FNA) is limited. We synthesized randomized trials to compare diagnostic performance, efficiency, and safety. METHODS: We searched MEDLINE (PubMed), Embase, Cochrane CENTRAL, Sco…

Vegetarian and vegan diets and cancer incidence: a systematic review and meta-analysis of prospective studies.

European journal of epidemiology · 2026 · PMID 41879966

Several studies have suggested that vegetarian and vegan vs. non-vegetarian diets are associated with lower cancer risk overall, however, results for specific cancer sites have been less consistent. We conducted a systematic review and meta-analysis of prospective studies on vegetarian and vegan diets and cancer incidence to clarify the associations across cancer sites. PubMed and Embase databases were searched for relevant studies up to 5 July 2025. Summary relative risks (RRs) and 95% confidence intervals (95% CI…

Development and validation of an epidemiological risk score for early detection of pancreatic cancer in high-risk individuals within the IMAGene project.

International journal of epidemiology · 2026 · PMID 42160519

BACKGROUND: Early detection is critical in pancreatic ductal adenocarcinoma (PDAC)-one of the most lethal malignancies due to its typically late diagnosis. METHODS: In this study, we aimed to validate an epidemiological risk score (ERS) designed to identify individuals at increased risk of developing PDAC prior to the use of imaging or other diagnostic procedures. The ERS was constructed through a meta-analysis of 24 well-established epidemiological risk factors. We applied this score to a prospective cohort of 178…

Covered self-expandable metal stents in benign biliary strictures caused by chronic pancreatitis: a randomized controlled trial of 6 versus 12 months of stenting.

Surgical endoscopy · 2026 · PMID 42151467

BACKGROUND: In chronic pancreatitis (CP), a symptomatic benign biliary stricture (BBS) evolves as an adverse event in 3-30%. Treatment by ERCP with a single plastic biliary stent has been disappointing. Multiple plastic stents are more successful but make the procedure more time consuming than treatment with a fully covered self-expandable metal stent (fcSEMS). The most efficient stenting duration of BBS caused by CP is not known. The aim of this multicenter prospective randomized study was to compare the safety an…

Precipitation-based versus filtration-based liquid-based cytology in endoscopic ultrasound-guided fine-needle biopsy specimens of solid pancreatic masses: a prospective, randomized trial (with video).

Gastrointestinal endoscopy · 2026 · PMID 41223974

BACKGROUND AND AIMS: EUS-guided fine-needle biopsy (FNB) is the standard technique for diagnosing solid pancreatic masses, offering high histologic accuracy. However, adequate tissue acquisition can still be difficult in small or technically demanding lesions. Liquid-based cytology (LBC) may serve as a complementary tool to improve diagnostic yield. This study compared the diagnostic efficacy and cytomorphologic features of 2 LBC techniques-precipitation-based SurePath and filtration-based ThinPrep-using cytologic …

Modified FOLFIRINOX with or Without Stereotactic Body Radiation in Locally Advanced Unresectable Pancreatic Cancer (SABER): A Randomized Open-Label Phase 2 Trial.

Annals of surgical oncology · 2026 · PMID 42098550

BACKGROUND: Prospective data on stereotactic body radiation therapy (SBRT) combined with modified 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin (mFOLFIRINOX) in patients with locally advanced unresectable pancreatic adenocarcinoma (PDAC) are limited. PATIENTS AND METHODS: The SABER trial was an open-label, randomized, phase 2 study. Patients with locally advanced, unresectable PDAC were eligible if they were suitable for SBRT with adherence to organ-at-risk constraints. Participants were randomized (1:1) …

Serum Biomarkers and CT-Derived Muscle Indices in Sarcopenia Associated with Pancreatic Neoplasm: A Comparative Clinical Study.

Chirurgia (Bucharest, Romania : 1990) · 2026 · PMID 42084250

Background: Sarcopenia is a frequent and clinically relevant condition in patients with pancreatic neoplasm, contributing to poor prognosis, reduced therapeutic tolerance, and increased mortality. The identification of reliable circulating biomarkers, alongside imaging-based muscle assessment, may improve early detection and risk stratification. Methods: This randomized prospective study included 61 patients, of whom 36 had pancreatic neoplasm associated with sarcopenia and 25 served as controls. Serum levels of os…

Serplulimab combined with gemcitabine, nab-paclitaxel, and stereotactic body radiotherapy versus gemcitabine and nab-paclitaxel as first-line treatment for recurrent or metastatic pancreatic ductal adenocarcinoma: a randomized, open-label, multicenter, phase III clinical trial (WGOG-PAN 006/ICSBR-2).

Frontiers in immunology · 2026 · PMID 42212134

BACKGROUND: Pancreatic ductal adenocarcinoma remains a malignancy with a dismal prognosis, characterized by a median overall survival of less than one year in the metastatic setting despite standard-of-care chemotherapy regimens like gemcitabine plus nab-paclitaxel. The PDAC tumor microenvironment is notoriously immunosuppressive, rendering single-agent immune checkpoint inhibitors largely ineffective. Stereotactic Body Radiotherapy has emerged as a potential strategy to induce immunogenic cell death and remodel th…

Trimodal Prehabilitation with Supervised Exercise during Neoadjuvant Chemotherapy in Localized Pancreatic Cancer.

Medicine and science in sports and exercise · 2026 · PMID 41430738

BACKGROUND: Pancreatic cancer (PC) is highly lethal, with surgery as the only curative option, but significant postoperative morbidity. Prehabilitation shows promise in other cancers, yet no trials have examined supervised exercise during neoadjuvant chemotherapy in PC. OBJECTIVES: The primary objective was to evaluate recruitment and adherence to a trimodal prehabilitation program during neoadjuvant chemotherapy in patients with nonmetastatic PC. Secondary aims included assessing changes in physical condition, fat…

Mesopancreas excision in pancreatic ductal adenocarcinoma: recurrence patterns - a single-arm descriptive study.

World journal of surgical oncology · 2026 · PMID 42324571

BACKGROUND: Mesopancreas excision has emerged as a critical component of pancreaticoduodenectomy for pancreatic ductal adenocarcinoma (PDAC), potentially improving oncological outcomes. However, comprehensive data on recurrence patterns following mesopancreas excision remain limited. OBJECTIVE: To analyze recurrence patterns in patients with PDAC who underwent pancreaticoduodenectomy with mesopancreas excision at a tertiary care center in Egypt. METHODS: This single-arm, single-center, retrospective descriptive coh…

Laparoscopic versus open pancreaticoduodenectomy for non-pancreatic periampullary adenocarcinomas: study protocol for a multicentre randomised controlled trial in China.

BMJ open · 2026 · PMID 42409398

INTRODUCTION: Pancreaticoduodenectomy (PD) is the preferred surgical approach for resectable periampullary carcinomas. Non-pancreatic periampullary carcinomas (NPPC) demonstrate distinct biological behaviours and are generally less aggressive than pancreatic cancer. Despite over three decades of advancements, the role of laparoscopic PD (LPD) remains debated. Few studies have directly compared LPD and open PD (OPD) while accounting for tumour invasiveness, and the data specifically evaluating LPD vs OPD for NPPC ar…

Impact of Hypertrophy-Oriented Resistance Training on Muscle Mass and Quality of Life in Patients with Unresectable Pancreatic Cancer (HY-PANC): Study Protocol for a Randomized Controlled Trial.

Current protocols · 2026 · PMID 42461827

BACKGROUND: Unresectable pancreatic cancer (PC) is characterized by a high prevalence of sarcopenia and cachexia, which negatively impact survival, treatment toxicity, and quality of life (QoL). Currently, evidence evaluating exercise programs in this vulnerable population is limited. METHODS: This prospective, two-arm randomized controlled trial (RCT) will recruit patients with unresectable PC undergoing chemotherapy. Participants will be randomized (1:1) to an intervention group (hypertrophy-oriented resistance t…

Adjuvant stereotactic pancreatic radiotherapy (SPARTA trial): interim safety analysis of an ongoing phase II single center prospective study.

Radiation oncology (London, England) · 2026 · PMID 42129843

AIMS: This interim safety/toxicity analysis aims to assess toxicity of adjuvant stereotactic body radiation therapy (SBRT) after surgery of pancreatic cancer (PC) with high risk features across an ongoing prospective phase II trial, allowing better integration of chemotherapy and surgery. METHODS: The study started in 2021 and this paper represents an interim safety analysis. Enrollment will last 36 months, followed by 12 months of follow-up for a duration of 4 years and 50 patients. Inclusion criteria are: pT1-T4 …

Semiannual surveillance facilitates detection of surgically treatable intraductal papillary mucinous neoplasm-derived and concomitant carcinoma: a multicenter prospective observational study.

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · 2026 · PMID 42399187

BACKGROUND: Intraductal papillary mucinous neoplasm (IPMN) is a well-recognized precursor of pancreatic cancer; however, the optimal surveillance strategy for IPMN remains controversial. This study aimed to evaluate the clinical impact of semiannual surveillance using endoscopic ultrasonography (EUS) and magnetic resonance imaging (MRI) for the detection of malignant transformation, including IPMN-derived and concomitant carcinoma. METHODS: This multicenter prospective observational study included 360 patients with…

Metabolic signatures of lipid dysregulation and inflammation characterize pancreatic cancer risk in type 2 diabetes mellitus and improve risk stratification: a prospective cohort study.

Diabetes research and clinical practice · 2026 · PMID 41905411

BACKGROUND: Type 2 diabetes mellitus (T2DM) increases pancreatic cancer (PC) risk, but specific metabolic mechanisms and effective risk stratification tools remain lacking. We aimed to identify metabolic features statistically accounting for this risk and construct a metabolic risk score (MRS). METHODS: We analyzed 445,931 UK Biobank participants with NMR metabolomics, excluding early PC cases to minimize reverse causality. Cox models estimated associations and calculated the proportion of the T2DM-PC association s…

Development and internal validation of a clinical risk prediction model for pancreatic ductal adenocarcinoma in the UK Biobank.

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 42068760

INTRODUCTION: Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal cancers. Earlier identification through improved risk prediction modelling represents a promising strategy for improving PDAC outcomes. We developed a PDAC risk prediction model using routinely available clinical risk factors, including modifiable factors, to enable targeted screening. METHODS: Data from the UK Biobank, a prospective cohort of adults aged 40-69 years recruited between 2006 and 2010, were used to develop a PDAC risk…

Effect of biliary drainage and biliary tract infection in unresectable pancreatic cancer treated with nanoliposomal irinotecan with fluorouracil and folinic acid: a multicenter, prospective cohort study (NAPOLEON-2).

BMC cancer · 2026 · PMID 42192328

BACKGROUND: The effectiveness and safety of nanoliposomal irinotecan with fluorouracil and folinic acid (NFF) in patients with unresectable or recurrent pancreatic cancer with or without prior biliary drainage (BD) or on-treatment biliary tract infection (BTI) in the real world are unclear. Pancreatic cancer can lead to BTIs, and having a BTI during chemotherapy may require antibiotics or biliary intervention, interrupt treatment, and reduce the intensity of the chemotherapy dose. Therefore, we analyzed the clinica…

Diagnostic yield of endoscopic ultrasound-guided fine-needle biopsy of solid pancreatic lesions with tissue sent directly in formalin for histopathologic evaluation compared with cytology: a multicenter prospective pilot study.

Gastrointestinal endoscopy · 2026 · PMID 41412424

BACKGROUND AND AIMS: Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is widely used to evaluate solid pancreatic lesions (SPLs). Although, traditionally, samples are sent for cytopathologic evaluation in cytology media, histopathologic analysis may offer advantages in centers without on-site cytopathologists. METHODS: We conducted a multicenter, prospective study of EUS-FNB samples from patients with SPLs, submitted for histopathologic evaluation with macroscopic on-site evaluation (MOSE). Diagnostic accu…

DNA/RNA-Based Next-Generation Sequencing Improves the Early Diagnosis and Management of Neoplastic Bile Duct Strictures: A 6-Year, Prospective, Multi-Institutional, Real-Time Study.

Gastroenterology · 2026 · PMID 41905432

BACKGROUND & AIMS: The distinction between benign and neoplastic bile duct strictures remains challenging. Pathologic assessment of endoscopic retrograde cholangiopancreatography (ERCP)-obtained specimens has limited sensitivity, particularly among patients with primary sclerosing cholangitis (PSC). Next-generation sequencing of bile duct specimens provides a promising diagnostic approach, but a prospective, multi-institutional, and comprehensive DNA/RNA analysis is lacking. METHODS: A 6-year, prospective, multi-in…

Type 2 Diabetes, Glycemic Traits and Overall Cancer Risk: A Large-Scale Prospective Cohort Study.

Cancer medicine · 2026 · PMID 42144703

BACKGROUND: Evidence concerning the associations of T2D and glycemic traits with overall cancer risk and their combined effect with genetic susceptibility remains inconsistent and unexplored. METHODS: This large-scale prospective cohort study included 475,637 eligible participants from the UK Biobank. We identified 25,887 participants with T2D by clinical data, baseline self-report data, and biochemistry data. HbA1c and random blood glucose were measured at baseline. The associations of T2D, HbA1c, and random blood…

Higher Daytime Light Exposure Predicts Lower Risk of Gastrointestinal Cancer Incidence and Mortality.

International journal of cancer · 2026 · PMID 42071269

Daytime light exposure is essential for health, primarily by synchronizing tissue and cellular-level clocks with the external light/dark cycle. Insufficient exposure may disrupt circadian alignment and contribute to adverse outcomes, including cancer. Given the high prevalence of gastrointestinal cancer, we conducted a prospective cohort study of 89,069 participants with objectively measured daytime light intensity and duration. Cox proportional hazards models were used to evaluate associations with gastrointestina…

Vivascope for real-time diagnosis of pancreatic solid lesion: A multicentre study.

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2026 · PMID 42185110

BACKGROUND: Fluorescence Confocal laser microscopy (FCM) with Vivascope in EUS-fine needle biopsy (FNB) samples of pancreatic solid lesion has shown good concordance with final histological evaluation.To assess the accuracy of Vivascope in predicting the diagnosis of EUS-guided pancreatic solid lesions samples.To assess the agreement between Vivascope and final histological diagnosis and the possible association between type and size of needles and the histological diagnosis obtainment. METHODS: Multicentre prospec…

Prediction of cancer-associated thrombosis by machine learning: results from the Vienna Cancer and Thrombosis Study.

ESMO open · 2026 · PMID 42202491

BACKGROUND: Improved risk prediction of cancer-associated venous thromboembolism (VTE) remains an unmet clinical need. We aimed to apply machine learning for the prediction of cancer-associated VTE. PATIENTS AND METHODS: Data from the Vienna Cancer and Thrombosis Study (Vienna-CATS), a prospective cohort study that included patients with cancer from 2003-2019, were used. Patient characteristics and laboratory measurements (including various routine and experimental laboratory assays) were used to train and validate…

Vitamin C as an Adjunctive Therapy in Cancer: A Systematic Review and Meta-Analysis of Outcomes in Solid and Hematologic Malignancies.

American journal of clinical oncology · 2026 · PMID 42507830

OBJECTIVES: Vitamin C has gained interest as an adjunctive treatment in oncology due to its antioxidant effects, potential to enhance cancer therapy, and ability to improve quality of life. This systematic review and meta-analysis aimed to assess the therapeutic impact of vitamin C in patients with solid and hematologic malignancies. METHODS: A comprehensive search was conducted in PubMed, Cochrane, Embase, ClinicalTrials.gov, and Google Scholar from inception to August 2025, in accordance with PRISMA guidelines. A…

Mistletoe extract in patients with advanced pancreatic cancer: Health-related quality of life in a double-blind, randomized, placebo-controlled trial (MISTRAL).

Palliative medicine · 2026 · PMID 42059487

BACKGROUND: Mistletoe extract is a widespread complementary therapy mainly used for quality-of-life improvement in cancer patients. Advanced pancreatic cancer is associated with poor quality of life and better therapies for symptomatic relief are highly needed. AIM: MISTRAL aimed to assess the impact of mistletoe extract on quality of life, body weight, observed costs and blood biomarkers in patients with advanced pancreatic cancer. DESIGN: MISTRAL was an investigator-initiated, phase III, randomized, double-blind,…

Daraxonrasib or Chemotherapy in Previously Treated Metastatic Pancreatic Cancer.

The New England journal of medicine · 2026 · PMID 42223072

BACKGROUND: Current therapies offer limited benefit for patients with previously treated metastatic pancreatic ductal adenocarcinoma (mPDAC). Aberrant activation of the RAS pathway is the key driver of PDAC, with oncogenic RAS mutations present in more than 90% of cases. Daraxonrasib is an oral RAS(ON) multiselective, tri-complex inhibitor of the active guanosine triphosphate-bound state of mutant and wild-type RAS. METHODS: In this phase 3, international, open-label, randomized trial, we randomly assigned patients…

The Epidemiology of PRSS1 Hereditary Pancreatitis and its Clinical Implications: A Systematic Review.

Pancreas · 2026 · PMID 42132515

OBJECTIVES: PRSS1-associated hereditary pancreatitis (HP) is a rare autosomal dominant disorder characterized by early disease onset. Although PRSS1 variants are recognized pathogenic factors, the epidemiology and clinical phenotype of PRSS1 hereditary pancreatitis remain inconsistently reported. This systematic review consolidates current evidence to define the genetic landscape, clinical profile, and implications for diagnosis and management. METHODS: Following PRISMA guidelines, MEDLINE, EMBASE, and Cochrane CEN…

Second-line liposomal irinotecan plus S-1 vs. liposomal irinotecan plus 5-fluorouracil in metastatic pancreatic cancer: The phase I/II randomized NAPAN trial.

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 41921365

BACKGROUND: This study aimed to determine the optimal second-line treatment strategy in patients with metastatic pancreatic cancer, hypothesizing that liposomal irinotecan (nal-IRI) combined with S-1 would be superior to nal-IRI with 5-fluorouracil (5-FU)/leucovorin (LV). METHODS: This was an international, multi-center, open-label, randomized phase I/II superiority trial. Patients with pancreatic adenocarcinoma, previously treated with gemcitabine-based treatment, were enrolled. Patients were randomly allocated to…

Depression as a potential early indicator of pancreatic cancer: a systematic review of prevalence, mechanisms, and temporal associations.

Journal of psychosocial oncology · 2026 · PMID 42246226

BACKGROUND: Pancreatic cancer (PC) remains one of the most lethal malignancies, with a five-year survival rate of only 12%, largely due to late diagnosis. Depression is frequently reported in PC and may precede its onset, yet underlying mechanisms remain unclear. AIMS: This systematic review examined (1) the prevalence of depression in PC, (2) potential psychological, clinical, and biological mechanisms, and (3) the temporality of depressive symptoms relative to PC diagnosis. METHODS: Following PRISMA guidelines, E…

[177Lu]Lu-dota-tate versus sunitinib in patients with metastatic progressive neuroendocrine tumours of the pancreas (OCLURANDOM): a randomised, controlled, phase 2 trial.

The Lancet. Oncology · 2026 · PMID 42225102

BACKGROUND: To our knowledge, no randomised trial with peptide receptor radionuclide therapy has been done in patients with metastatic pancreatic neuroendocrine tumours. We aimed to evaluate the antitumour activity and safety of [177Lu]Lu-dota-tate in this setting. METHODS: OCLURANDOM is a randomised, open-label, non-comparative, phase 2 trial conducted in ten academic centres in France. Patients aged 18 years and older with pretreated, progressive, somatostatin receptor-positive, metastatic pancreatic neuroendocri…

Robot-assisted versus open pancreatoduodenectomy for cancer in the pancreatic head (DIPLOMA-2x2): study protocol for an international multicentre patient- and assessor-blinded randomized controlled non-inferiority trial.

Trials · 2026 · PMID 42464359

BACKGROUND: Robot-assisted pancreatoduodenectomy (RPD) is increasingly performed for cancer in the pancreatic head. Randomised evidence confirming its oncological safety and efficacy is lacking. The DIPLOMA-2x2 trial aims to compare the oncological safety of RPD versus OPD in terms of radicality (microscopically radical resection [R0] resection). We hypothesise that RPD is non-inferior to OPD in terms of radicality and superior regarding time to functional recovery. METHODS: The DIPLOMA-2x2 trial is an investigator…

Trimodal Prehabilitation with Supervised Exercise during Neoadjuvant Chemotherapy in Localized Pancreatic Cancer.

Medicine and science in sports and exercise · 2026 · PMID 41430738

BACKGROUND: Pancreatic cancer (PC) is highly lethal, with surgery as the only curative option, but significant postoperative morbidity. Prehabilitation shows promise in other cancers, yet no trials have examined supervised exercise during neoadjuvant chemotherapy in PC. OBJECTIVES: The primary objective was to evaluate recruitment and adherence to a trimodal prehabilitation program during neoadjuvant chemotherapy in patients with nonmetastatic PC. Secondary aims included assessing changes in physical condition, fat…

Sequential alternation of nal-IRI/5-FU and gemcitabine/nab-paclitaxel versus nal-IRI/5-FU versus gemcitabine/nab-paclitaxel in first-line metastatic pancreatic cancer: results of the randomized phase II PRODIGE 61-FUNGEMAX trial (France).

EClinicalMedicine · 2026 · PMID 42256682

BACKGROUND: New chemotherapeutic approaches are still needed to improve survival and quality of life in metastatic pancreatic ductal adenocarcinoma (mPDAC). In the absence of validated predictive biomarkers, first-line sequential treatment strategies may allow to delay chemoresistance and reduce cumulative side effects. METHODS: PRODIGE 61-FUNGEMAX was an open-label, multicentre, randomised phase II trial conducted in 31 centres in France. Between November 2018 and January 2024, chemotherapy-naive patients aged 18-…

Living With Advanced Pancreatic Cancer: Patients' Experiences of Daily Life.

Psycho-oncology · 2025 · PMID 40903211

BACKGROUND: Pancreatic cancer is often diagnosed in late stages of the disease with only a 10% 5-year survival. The disease is associated with complex symptoms and psychological distress. AIMS: The specific objective of this qualitative study was to explore patients' experiences of what symptoms and distress that had impact on their everyday life. METHODS: We interviewed 31 patients with advanced pancreatic cancer nested within a randomized controlled study, called MISTRAL, about their everyday life using a semi st…

Laparoscopic versus open pancreaticoduodenectomy for non-pancreatic periampullary adenocarcinomas: study protocol for a multicentre randomised controlled trial in China.

BMJ open · 2026 · PMID 42409398

INTRODUCTION: Pancreaticoduodenectomy (PD) is the preferred surgical approach for resectable periampullary carcinomas. Non-pancreatic periampullary carcinomas (NPPC) demonstrate distinct biological behaviours and are generally less aggressive than pancreatic cancer. Despite over three decades of advancements, the role of laparoscopic PD (LPD) remains debated. Few studies have directly compared LPD and open PD (OPD) while accounting for tumour invasiveness, and the data specifically evaluating LPD vs OPD for NPPC ar…

Nutritional Therapy in Pancreatic Cancer: Mechanisms, Clinical Applications, and Future Perspectives.

Nutrition and cancer · 2026 · PMID 42411702

BACKGROUND: Pancreatic cancer is frequently complicated by malnutrition, cancer cachexia, pancreatic exocrine insufficiency (PEI), and sarcopenia, all of which adversely affect treatment tolerance, quality of life, and survival. OBJECTIVE: To review the pathophysiology, assessment, and contemporary nutritional management of pancreatic cancer, with a focus on cachexia, PEI, body composition, and personalized nutritional care. METHODS: This narrative review summarizes evidence from clinical guidelines, randomized tri…

Impact of Hypertrophy-Oriented Resistance Training on Muscle Mass and Quality of Life in Patients with Unresectable Pancreatic Cancer (HY-PANC): Study Protocol for a Randomized Controlled Trial.

Current protocols · 2026 · PMID 42461827

BACKGROUND: Unresectable pancreatic cancer (PC) is characterized by a high prevalence of sarcopenia and cachexia, which negatively impact survival, treatment toxicity, and quality of life (QoL). Currently, evidence evaluating exercise programs in this vulnerable population is limited. METHODS: This prospective, two-arm randomized controlled trial (RCT) will recruit patients with unresectable PC undergoing chemotherapy. Participants will be randomized (1:1) to an intervention group (hypertrophy-oriented resistance t…

High-Intensity Interval Training Boosts Immune Cells in Advanced Cancer Patients and Healthy Controls: Implications for Cancer Care.

Cancer medicine · 2026 · PMID 42233178

BACKGROUND: Regular exercise improves quality of life (QoL) and reduces fatigue in advanced cancer patients (ACP), but acute immune responses are underexplored. This study investigated the effects of a single high-intensity interval training (HIIT) session on natural killer (NK) cells and circulating innate lymphoid cells (cILCs) in ACP. METHODS: An ACP group undergoing chemotherapy (PG, n = 20, 59.8 ± 10.3 years, 70% pancreatic cancer) was compared with age-matched healthy controls (HG, n = 19, 60.7 ± 10.6 years).…

Correction: Impact of Hypertrophy-Oriented Resistance Training on Muscle Mass and Quality of Life in Patients with Unresectable Pancreatic Cancer (HY-PANC): Study Protocol for a Randomized Controlled Trial.

Current protocols · 2026 · PMID 42519871

Patient-derived Organoid Pharmacotyping as a Predictive Tool for Therapeutic Selection in Pancreatic Ductal Adenocarcinoma.

Annals of surgery · 2026 · PMID 39229726

OBJECTIVE: To integrate a new approach to chemosensitivity data for clinically relevant regimen matching, and demonstrate the relationship with clinical outcomes in a large patient-derived organoid (PDO) biobank. BACKGROUND: Pancreatic ductal adenocarcinoma usually recurs following potentially curative resection. Prior studies related PDO chemosensitivity with clinical responses. METHODS: PDOs were established from pretreatment biopsies in a multi-institution clinical trial (n = 21) and clinical specimens at a high…

Treatment landscape from first- to third-line therapy and quality of life data of patients with pancreatic cancer from the prospective German PARAGON (Platform for Outcome, Quality of Life, and Translational Research on Pancreatic Cancer) registry (IKF-PARAGON study).

International journal of cancer · 2026 · PMID 41388765

Pancreatic cancer (PCA) is the third leading cause of cancer-related death in Europe. Despite recent therapeutic advances, patients experience rapid health deterioration. Based on previous results, the Platform for Outcome, Quality of Life, and Translational Research on Pancreatic Cancer-PARAGON (NCT04119362) was initiated to investigate the whole life cycle of PCA patients. Between November 2019 and October 2021, 469/479 screened patients were enrolled in 46 sites. Demographic, clinical, and quality of life (QoL) …

Factors associated with changes in quality of life after pancreaticoduodenectomy for periampullary tumors.

Frontiers in surgery · 2026 · PMID 42125604

INTRODUCTION: Pancreaticoduodenectomy for periampullary tumors is a complex surgery with potential complications and long recovery, impacting patients' quality of life (QoL). This study evaluates QoL changes from preoperative status to 12 months post-surgery. METHODS: A prospective cohort study was conducted at the University Medical Center of Ho Chi Minh City from January 2019 to May 2021. Patients undergoing pancreaticoduodenectomy (laparoscopic or open) were assessed using the SF-36 questionnaire at baseline, 1,…

Physical Function and Its Association With Quality of Life in Pancreatic Cancer Patients Receiving Chemotherapy.

Journal of physical activity & health · 2026 · PMID 41569816

BACKGROUND: The relationship between changes in physical function and quality of life in pancreatic cancer patients undergoing chemotherapy is not yet fully understood. This study aimed to examine the physical function trajectories and their relationship with the quality of life in these patients. METHODS: A total of 273 patients with pancreatic cancer were recruited for this study. Three physical functional tests (maximum grip strength, 2-minute step test [2-MST], and timed up and go) were performed at baseline (b…

Racial Disparities in Non-Stigmatized Supportive Care Medication Use in Pancreatic Cancer.

Journal of pain and symptom management · 2026 · PMID 41785943

BACKGROUND: Pancreatic cancer (PC) is associated with a high symptom burden that contributes to reduced health-related quality of life (HRQoL) and adverse clinical outcomes. Supportive care medications (SCMs) are essential for symptom management. Prior studies have documented racial disparities in the use of stigmatized medication classes such as opioids and psychotropics. However, less is known about whether similar disparities exist for non-stigmatized SCMs. This study examined racial and ethnic differences in th…

The impact of age on quality of life, 90-day mortality, adjuvant chemotherapy, and survival after treatment for localized pancreatic cancer: A nationwide analysis.

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 42208281

BACKGROUND: Pancreatic cancer has a poor prognosis. Multiple treatment modalities are available, their impact on health-related quality of life (HRQoL) and overall survival (OS) in older patients remains unclear. This study compared HRQoL, postoperative mortality, adjuvant chemotherapy use and OS after various treatment strategies between elderly and younger patients with localized pancreatic cancer. METHODS: In this nationwide cohort study (2015-2023), patients with localized pancreatic cancer (resectable, borderl…

Association between Main Pancreatic Duct Size, Comorbidities, and Fistula Formation after Whipple Procedure for Pancreatic Cancer.

Southern medical journal · 2026 · PMID 42229555

OBJECTIVE: Studies have associated abnormally dilated or constricted main pancreatic duct (MPD) diameter sizes in postproximal pancreatectomies (Whipple procedures) with postoperative complications. As such, we studied the clinical factors associated with both abnormally dilated or constricted MPD diameters and perioperative factors that may influence postoperative pancreatic fistula formation. METHODS: We analyzed Whipple procedure cases for pancreatic cancer in the 2019-2021 American College of Surgeons National …

Assessing Patient Characteristics in Neuroendocrine Tumor Research: A Comparison of the NET-PRO Study to SEER Population-Based Data.

Endocrine · 2026 · PMID 42043735

PURPOSE: We compared demographic and clinical characteristics of patients with gastroenteropancreatic (GEP) and lung neuroendocrine tumors (NETs) enrolled in the NET-PRO study to those in the U.S. Surveillance Epidemiology and End Results (SEER) program to evaluate the comparability of NET-PRO as a resource for real-world evidence generation and patient reported outcomes (PROs). METHODS: NET-PRO enrolled adults with GEP or lung NETs from 14 health systems between 2018 and 2024. SEER data included patients diagnosed…

Pain prevalence and intensity in advanced pancreatic cancer: a nationwide cohort study.

Pain · 2026 · PMID 42402901

Pain is a major concern in patients with advanced pancreatic cancer, significantly affecting quality of life, treatment tolerance, and end-of-life experience. However, data on its prevalence, course, and determinants remain limited, particularly regarding the dynamics of pain as a primary outcome in real-world patient populations. This nationwide cohort study, conducted within the PACAP-PROM registry (2016-2023), included patients with locally advanced (LAPC) or metastatic pancreatic cancer (mPC). Pain was assessed…

Glucagon-like peptide-1 receptor agonists and the risk of obesity-related cancers: a systematic review and meta-analysis.

Diabetes research and clinical practice · 2026 · PMID 41722869

BACKGROUND: Type 2 diabetes mellitus (T2DM) and obesity are increasing and are established risk factors for malignancy. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used for T2DM and obesity, but their association with cancer risk remains uncertain. We assessed the association between GLP-1RA use and obesity-related cancers. METHODS: We searched Embase, PubMed, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to 20 November 2025. Observational studies and randomized…

Effect of duration of neoadjuvant therapy on pancreatic cancer outcomes: a systematic review and meta-analysis.

HPB : the official journal of the International Hepato Pancreato Biliary Association · 2026 · PMID 41475907

BACKGROUND: The aim of theis study was toevaluate impact of duration of neoadjuvant treatment (NAT) on surgical resection rate, resection margin, response to treatment, and survival in patients with pancreatic ductal adenocarcinoma (PDAC). METHODS: All randomised controlled trials (RCTs) of NAT in patients with PDAC were included. Effect sizes were determined for surgical resection rate, R0 resection, radiological response to NAT and 1- to 5-years survival. RESULTS: Twenty-three RCTs (1880 patients) were included. …

Neoadjuvant Treatment Versus Upfront Surgery for Resectable Pancreatic Ductal Adenocarcinoma-A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Medicina (Kaunas, Lithuania) · 2026 · PMID 42356062

Background and Objectives: The role of neoadjuvant or perioperative treatment in anatomically resectable pancreatic ductal adenocarcinoma (PDAC) remains intensely debated, in part because prior evidence syntheses have often pooled resectable and borderline-resectable disease. We aim to evaluate the efficacy and safety of neoadjuvant or perioperative treatment versus upfront surgery in trial-defined resectable PDAC using randomized evidence only. Materials and Methods: We performed a systematic review and meta-analy…

Reverse-Bevel (ProCore) EUS-Guided Fine-Needle Biopsy for Solid Pancreatic Mass Lesions: a GRADE-Assessed Systematic Review and Meta-Analysis of Prospective Randomized Trials.

Journal of gastrointestinal cancer · 2026 · PMID 42406286

BACKGROUND AND AIMS: Endoscopic ultrasound-guided tissue acquisition is used to diagnose pancreatic mass lesions, but optimal needle selection remains uncertain. Reverse bevel ProCore fine needle biopsy (FNB) needles aim to enhance histologic procurement and reduce sampling burden; randomized evidence versus standard fine needle aspiration (FNA) is limited. We synthesized randomized trials to compare diagnostic performance, efficiency, and safety. METHODS: We searched MEDLINE (PubMed), Embase, Cochrane CENTRAL, Sco…

Advancing precision immunotherapy in advanced pancreatic cancer: a systematic review and meta-analysis of first-line ICI-based combinations.

Frontiers in immunology · 2026 · PMID 42500667

OBJECTIVE: Pancreatic ductal adenocarcinoma (PDAC) has an extremely poor prognosis. Immune checkpoint inhibitor (ICI) monotherapy has shown limited efficacy in PDAC, whereas the potential clinical value of first-line ICI-based combination regimens remains unclear. Through a systematic review and meta-analysis, this study aimed to evaluate the efficacy and safety of first-line ICI-based combination regimens in advanced PDAC. METHODS: PubMed, Embase, The Cochrane Library, Scopus, Web of Science, CNKI, Wanfang Data, V…

The outcomes of surgical resection versus ablation of liver metastases from neuroendocrine tumors: A systematic review.

Hepatobiliary & pancreatic diseases international : HBPD INT · 2026 · PMID 42177126

BACKGROUND: Neuroendocrine liver metastases (NLMs) from gastroenteropancreatic neuroendocrine tumors (GEP-NETs) significantly impact morbidity and mortality. While surgical resection remains the standard treatment, radiofrequency ablation (RFA) has emerged as an alternative for unresectable cases. This systematic review compared the oncological outcomes of surgical resection and RFA. DATA SOURCES: A systematic search of PubMed, Web of Science, and Scopus identified studies published between 2014 and 2025. Eligible …

Activity and Physiological Stress Within 90 Days After Minimally Invasive and Open Pancreatoduodenectomy: A Predefined Analysis of the DIPLOMA-2 Randomized Clinical Trial.

JAMA surgery · 2026 · PMID 42160093

IMPORTANCE: Minimally invasive pancreatoduodenectomy (MIPD) aims to improve postoperative recovery compared with open pancreatoduodenectomy (OPD). However, it is unclear whether the benefits of MIPD extend beyond the initial hospital stay. OBJECTIVE: To assess postoperative recovery after hospital discharge-using activity tracking-in patients with upfront resectable neoplasm in the pancreatic head or periampullary region, comparing MIPD with OPD. DESIGN, SETTING, AND PARTICIPANTS: The patient-blinded DIPLOMA-2 rand…

Elraglusib and chemotherapy in metastatic pancreatic ductal adenocarcinoma: a randomized controlled phase 2 trial.

Nature medicine · 2026 · PMID 41981308

Metastatic pancreatic ductal adenocarcinoma (mPDAC) is one of the leading causes of cancer-related mortality, but advances in therapeutic treatments remain limited. Elraglusib (9-ING-41), an inhibitor of GSK-3β, exhibits a multimodal mechanism of action based on antitumor activity in preclinical models of cancer, including pancreatic. The efficacy and safety of elraglusib with gemcitabine plus nab-paclitaxel (GnP) were assessed in patients with previously untreated mPDAC. In an open-label, international, multicente…

Mesenteric Versus Conventional Approach During Pancreatoduodenectomy for Pancreatic Ductal Adenocarcinoma (MAPLE-PD trial): A Multicenter Randomized Controlled Trial.

Annals of surgery · 2026 · PMID 40772617

OBJECTIVE: This multicenter randomized controlled trial investigated whether the mesenteric approach, which is an infracolic superior mesenteric artery (SMA)-first approach during pancreatoduodenectomy (PD), can improve survival in patients with pancreatic ductal adenocarcinoma (PDAC), compared with the Kocher-first conventional approach. BACKGROUND: The mesenteric approach might improve surgical outcomes through a nontouch isolation technique for PDAC. METHODS: This trial was conducted in 24 Japanese high-volume c…

Impact of cytoreductive surgery with HIPEC in the treatment of pancreatic cancer with peritoneal carcinomatosis: A systematic review.

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2026 · PMID 42229165

Pancreatic cancer with peritoneal metastases is associated with a particularly poor prognosis under standard systemic therapy. This systematic review evaluates the role of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in this patient population, focusing on survival, recurrence, and treatment-related morbidity and mortality. Following PRISMA guidelines, a systematic search was conducted across MEDLINE, Web of Science, and SCOPUS. Study quality was assessed using the Methodologica…

Effect of polyunsaturated fatty acids supplementation on nutritional status in patients with pancreatic cancer: a systematic review and meta-analysis.

PeerJ · 2026 · PMID 42180603

BACKGROUND: Patients with pancreatic cancer frequently experience malnutrition that is often unresponsive to conventional nutritional interventions. OBJECTIVE: To evaluate the impact of n-3 polyunsaturated fatty acids (PUFAs), specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), supplementation on body weight (BW), lean body mass (LBM), body mass index (BMI), serum albumin (ALB), and serum prealbumin (PA) in this population. This systematic review was prospectively registered with PROSPERO (CRD4…

Perioperative and short-term oncological outcomes of laparoscopic versus open pancreaticoduodenectomy: an updated systematic review and meta-analysis of randomized controlled trials with GRADE evaluation.

BMC surgery · 2026 · PMID 42174581

BACKGROUND: Surgical resection through pancreatoduodenectomy (PD) represents the only curative option for periampullary and pancreatic head tumors. Recently, laparoscopic pancreatoduodenectomy (LPD) has emerged as a minimally invasive alternative to the open approach (OPD). However, the safety, feasibility, and short-term oncologic adequacy of LPD compared to OPD remain a matter of controversy. This systematic review and meta-analysis aimed to compare perioperative and short-term oncologic outcomes of LPD versus OP…

Neoadjuvant therapy versus upfront surgery for resectable pancreatic cancer: Updated systematic review, individual-patient-data meta-analysis and trial sequential analysis of randomized controlled trials.

Surgery · 2026 · PMID 41381268

BACKGROUND: The oncologic benefit of neoadjuvant therapy in resectable pancreatic ductal adenocarcinoma remains uncertain. We conducted an updated systematic review and meta-analysis to evaluate the efficacy of neoadjuvant therapy versus upfront surgery in patients with resectable pancreatic cancer. METHODS: Searches of various databases identified 9 randomized controlled trials comprising 604 neoadjuvant therapy and 527 upfront surgery patients. Hazard ratios for overall survival and event-free survival were extra…

Endoscopic Ultrasound-Guided Radiofrequency Ablation (EUS-RFA): Are We Getting Evidence-Based Results? A Systematic Review According to the Levels of Evidence.

Medicina (Kaunas, Lithuania) · 2026 · PMID 42512924

Background and Objectives: Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is an emerging minimally invasive therapeutic option for pancreatic and selected extra-pancreatic lesions. However, its clinical adoption is limited by heterogeneous indications, non-standardized techniques, and variable quality of evidence. This systematic review assessed the published literature on EUS-RFA and classified available evidence according to the Oxford Centre for Evidence-Based Medicine levels of evidence. Materia…

Mistletoe extract in patients with advanced pancreatic cancer: Health-related quality of life in a double-blind, randomized, placebo-controlled trial (MISTRAL).

Palliative medicine · 2026 · PMID 42059487

BACKGROUND: Mistletoe extract is a widespread complementary therapy mainly used for quality-of-life improvement in cancer patients. Advanced pancreatic cancer is associated with poor quality of life and better therapies for symptomatic relief are highly needed. AIM: MISTRAL aimed to assess the impact of mistletoe extract on quality of life, body weight, observed costs and blood biomarkers in patients with advanced pancreatic cancer. DESIGN: MISTRAL was an investigator-initiated, phase III, randomized, double-blind,…

Daraxonrasib or Chemotherapy in Previously Treated Metastatic Pancreatic Cancer.

The New England journal of medicine · 2026 · PMID 42223072

BACKGROUND: Current therapies offer limited benefit for patients with previously treated metastatic pancreatic ductal adenocarcinoma (mPDAC). Aberrant activation of the RAS pathway is the key driver of PDAC, with oncogenic RAS mutations present in more than 90% of cases. Daraxonrasib is an oral RAS(ON) multiselective, tri-complex inhibitor of the active guanosine triphosphate-bound state of mutant and wild-type RAS. METHODS: In this phase 3, international, open-label, randomized trial, we randomly assigned patients…

Impact of reinforced pancreaticojejunostomy with or without tissue adhesive glue modified cyanoacrylate following pancreaticoduodenectomy: a randomized controlled clinical trial.

World journal of surgical oncology · 2026 · PMID 42381068

BACKGROUND: Postoperative pancreatic fistula (POPF) remains the most significant complication following pancreaticoduodenectomy (PD). This randomized controlled trial evaluated the efficacy of reinforcing the pancreaticojejunostomy (PJ) with Glubran®2, a modified N-butyl-2-cyanoacrylate adhesive, in reducing the rate of clinically relevant POPF. METHODS: This single-center randomized controlled trial with blinded patients and blinded outcome assessors enrolled 100 consecutive patients undergoing open PD for pancrea…

[177Lu]Lu-DOTATATE PRRT and CAPTEM chemotherapy for pancreas and small bowel neuroendocrine tumours: The AGITG CONTROL NETS Multi-centre randomized trial.

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 42142431

BACKGROUND/AIM: To evaluate the efficacy of [177Lu]Lu-DOTATATE peptide receptor radionuclide therapy (PRRT) plus capecitabine and temozolomide (CAPTEM) in participants(pts) with progressive WHO Grade 1-2 neuroendocrine tumours: pancreas(pNETs) and small bowel(SBNETs). METHODS: Non-comparative randomized open label parallel group phase II trial, 2:1 randomization to PRRT/CAPTEM (experimental arm) vs PRRT (SBNETs control) and CAPTEM (pNETs control). PRRT/CAPTEM: 7.8 GBq [177Lu]Lu-DOTATATE i.v. Day 10, 8 weekly x 4, c…

A Multicenter Phase II Randomized Controlled Trial Comparing 177Lu-Dotatate/Capecitabine Combination Treatment with 177Lu-Dotatate Monotherapy in Patients with Neuroendocrine Tumors.

Clinical cancer research : an official journal of the American Association for Cancer Research · 2026 · PMID 41591997

PURPOSE: Peptide receptor radionuclide therapy (PRRT) with [177Lu]Lu-[DOTA0,Tyr3]octreotate (177Lu-Dotatate) is an effective and safe treatment for patients with metastatic gastroenteropancreatic neuroendocrine tumors (GEP NET). Whereas 177Lu-Dotatate prolongs progression-free survival (PFS) and preserves quality of life (QoL), objective response rates (ORR) remain limited. Capecitabine, as a radiosensitizer, could increase efficacy without increasing 177Lu-Dotatate activity. This phase II randomized controlled tri…

Second-line liposomal irinotecan plus S-1 vs. liposomal irinotecan plus 5-fluorouracil in metastatic pancreatic cancer: The phase I/II randomized NAPAN trial.

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 41921365

BACKGROUND: This study aimed to determine the optimal second-line treatment strategy in patients with metastatic pancreatic cancer, hypothesizing that liposomal irinotecan (nal-IRI) combined with S-1 would be superior to nal-IRI with 5-fluorouracil (5-FU)/leucovorin (LV). METHODS: This was an international, multi-center, open-label, randomized phase I/II superiority trial. Patients with pancreatic adenocarcinoma, previously treated with gemcitabine-based treatment, were enrolled. Patients were randomly allocated to…

Long-term oncological outcomes following algorithm-based care versus usual care for the early recognition and management of complications after pancreatic resection: a post-hoc analysis of a nationwide, stepped-wedge cluster-randomised trial.

The lancet. Gastroenterology & hepatology · 2026 · PMID 41662856

BACKGROUND: Studies have shown that severe postoperative complications after resection of pancreatic and periampullary cancer might have a negative effect on long-term oncological outcomes. The PORSCH trial showed that an algorithm for early recognition and minimally invasive management of complications after pancreatic resection significantly improved short-term clinical outcomes. The algorithm's effect on long-term survival remains to be determined. METHODS: Long-term oncological outcomes were evaluated post hoc …

Covered self-expandable metal stents in benign biliary strictures caused by chronic pancreatitis: a randomized controlled trial of 6 versus 12 months of stenting.

Surgical endoscopy · 2026 · PMID 42151467

BACKGROUND: In chronic pancreatitis (CP), a symptomatic benign biliary stricture (BBS) evolves as an adverse event in 3-30%. Treatment by ERCP with a single plastic biliary stent has been disappointing. Multiple plastic stents are more successful but make the procedure more time consuming than treatment with a fully covered self-expandable metal stent (fcSEMS). The most efficient stenting duration of BBS caused by CP is not known. The aim of this multicenter prospective randomized study was to compare the safety an…

Randomized phase III trial of gemcitabine plus nab-paclitaxel versus gemcitabine plus S-1 as neoadjuvant chemotherapy for resectable pancreatic cancer in geriatric patients: JCOG2101C (PRESTIGE study).

Japanese journal of clinical oncology · 2026 · PMID 41968990

Neoadjuvant gemcitabine plus S-1 (GS) followed by surgery and adjuvant S-1 is the standard of care for resectable pancreatic cancer. Since ~73% of newly diagnosed pancreatic cancer patients are aged ≥70, effective treatments are strongly needed in this geriatric population. In unresectable pancreatic cancer, gemcitabine plus nab-paclitaxel (GnP) is widely used, even among geriatric patients. To evaluate the survival advantage of neoadjuvant GnP over GS for geriatric patients with resectable pancreatic cancer, an op…

[177Lu]Lu-edotreotide versus everolimus for gastroenteropancreatic neuroendocrine tumours (COMPETE): a phase 3, multicentre, randomised, open-label, superiority trial.

Lancet (London, England) · 2026 · PMID 42392118

BACKGROUND: Peptide receptor radionuclide and targeted therapy are both approved treatment options for patients with metastatic gastroenteropancreatic neuroendocrine tumours (GEP NETs), but clinical evidence for preferred sequencing is scarce. The COMPETE trial evaluated the efficacy and harms of peptide receptor radionuclide therapy ([177Lu]Lu-edotreotide) versus targeted molecular therapy (everolimus) in patients with advanced, progressive, somatostatin receptor-positive GEP NETs. METHODS: This phase 3, open-labe…

Preoperative Biliary Drainage with Metal Stent Versus Early Surgery in Patients with Pancreatic Cancer: A Randomized Clinical Trial.

Annals of surgical oncology · 2026 · PMID 41951900

BACKGROUND: Among patients with pancreatic cancer and biliary obstruction planned for pancreaticoduodenectomy, preoperative biliary drainage (PBD) may be considered during surgical delays. Higher complication rates have been reported for PBD using plastic stents versus early surgery. PBD with a self-expanding metal stent (SEMS) has not been compared with early surgery in a randomized controlled trial (RCT). PATIENTS AND METHODS: We conducted a noninferiority RCT comparing PBD using a SEMS versus early surgery at 11…

Impact of postoperative pancreatic fistula (POPF) on long-term outcomes of patients who underwent pancreatic cancer resection: systematic review and meta-analysis.

Surgical oncology · 2026 · PMID 42242032

INTRODUCTION: Postoperative pancreatic fistula (POPF) is a major complication resulting from pancreatic resection. The long-term oncological outcomes of patients who experience POPF after pancreatic cancer resection remain inconclusive. The purpose of this study was to evaluate the impact of POPF on the long-term survival of patients undergoing pancreatic cancer resection. METHODS: A systematic review and meta-analysis were performed for studies comparing survival outcomes in patients with or without POPF following…

Robotic pancreaticoduodenectomy with venous resection and reconstruction: a systematic review of perioperative, vascular, oncological and survival outcomes.

Journal of robotic surgery · 2026 · PMID 42474838

Robotic pancreaticoduodenectomy with venous resection and reconstruction (RPD-VR) is one of the most technically challenging procedures in hepatopancreaticobiliary surgery. While acceptance of robotic pancreaticoduodenectomy is growing, the safety, feasibility, and oncologic adequacy of combined portal vein (PV) and/or superior mesenteric vein (SMV) resection remain incompletely defined. A systematic review was conducted following PRISMA guidelines. PubMed/MEDLINE, Scopus and the Cochrane Library were searched from…

Systematic Review and Pooled Analysis of 1,021 Children With Pancreatic Tumors.

The Journal of surgical research · 2026 · PMID 42335633

INTRODUCTION: Although relatively rare, pediatric pancreatic tumors have been increasingly reported in the literature. Our aim was to systematically review the literature on the clinical characteristics, management, and outcomes of pediatric pancreatic tumors. METHODS: We performed a systematic review of the MEDLINE, Scopus, Web of Science, and Cochrane Library databases (end-of-search date: June 2022) according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. RESULTS: Sixty-four…

The outcomes of surgical resection versus ablation of liver metastases from neuroendocrine tumors: A systematic review.

Hepatobiliary & pancreatic diseases international : HBPD INT · 2026 · PMID 42177126

BACKGROUND: Neuroendocrine liver metastases (NLMs) from gastroenteropancreatic neuroendocrine tumors (GEP-NETs) significantly impact morbidity and mortality. While surgical resection remains the standard treatment, radiofrequency ablation (RFA) has emerged as an alternative for unresectable cases. This systematic review compared the oncological outcomes of surgical resection and RFA. DATA SOURCES: A systematic search of PubMed, Web of Science, and Scopus identified studies published between 2014 and 2025. Eligible …

Defining textbook outcome for distal pancreatectomy by systematic review. Is it clinically relevant?

Surgery · 2026 · PMID 42134067

BACKGROUND: A textbook outcome is a composite score of individual metrics that report an ideal outcome for a given surgery. The objectives of this study were to develop and validate a textbook outcome definition for distal pancreatectomy. METHODS: PubMed, Embase, and Web of Science databases were searched until October 1, 2024 for this systematic review, and studies that evaluated textbook outcome for distal pancreatectomy were selected. Textbook outcome metrics were chosen by data strength and validated by reviewi…

Survival benefit of particle chemoradiotherapy in locally advanced unresectable pancreatic cancer: a systematic review and meta-analysis.

Therapeutic advances in gastroenterology · 2026 · PMID 42544125

BACKGROUND: The pros and cons of incorporating radiotherapy (RT) into chemotherapy (CT) for locally advanced unresectable pancreatic cancer (LAPC) have been debated for decades. Recently, particle (proton and carbon-ion) therapy has emerged as a new radiotherapy modality. Given the unclear benefits of this approach, we summarized clinical outcomes of LAPC treated with concurrent chemoradiotherapy (CRT) using particle therapy to compare outcomes with current treatments. OBJECTIVES: To evaluate the efficacy and safet…

Endoscopic Ultrasound-Guided Radiofrequency Ablation (EUS-RFA): Are We Getting Evidence-Based Results? A Systematic Review According to the Levels of Evidence.

Medicina (Kaunas, Lithuania) · 2026 · PMID 42512924

Background and Objectives: Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is an emerging minimally invasive therapeutic option for pancreatic and selected extra-pancreatic lesions. However, its clinical adoption is limited by heterogeneous indications, non-standardized techniques, and variable quality of evidence. This systematic review assessed the published literature on EUS-RFA and classified available evidence according to the Oxford Centre for Evidence-Based Medicine levels of evidence. Materia…

Daraxonrasib or Chemotherapy in Previously Treated Metastatic Pancreatic Cancer.

The New England journal of medicine · 2026 · PMID 42223072

BACKGROUND: Current therapies offer limited benefit for patients with previously treated metastatic pancreatic ductal adenocarcinoma (mPDAC). Aberrant activation of the RAS pathway is the key driver of PDAC, with oncogenic RAS mutations present in more than 90% of cases. Daraxonrasib is an oral RAS(ON) multiselective, tri-complex inhibitor of the active guanosine triphosphate-bound state of mutant and wild-type RAS. METHODS: In this phase 3, international, open-label, randomized trial, we randomly assigned patients…

[177Lu]Lu-edotreotide versus everolimus for gastroenteropancreatic neuroendocrine tumours (COMPETE): a phase 3, multicentre, randomised, open-label, superiority trial.

Lancet (London, England) · 2026 · PMID 42392118

BACKGROUND: Peptide receptor radionuclide and targeted therapy are both approved treatment options for patients with metastatic gastroenteropancreatic neuroendocrine tumours (GEP NETs), but clinical evidence for preferred sequencing is scarce. The COMPETE trial evaluated the efficacy and harms of peptide receptor radionuclide therapy ([177Lu]Lu-edotreotide) versus targeted molecular therapy (everolimus) in patients with advanced, progressive, somatostatin receptor-positive GEP NETs. METHODS: This phase 3, open-labe…

Preoperative mFOLFIRINOX versus PAXG for stage I-III resectable and borderline resectable pancreatic ductal adenocarcinoma (PACT-21 CASSANDRA): results of the first randomisation analysis of a randomised, open-label, 2 × 2 factorial phase 3 trial.

Lancet (London, England) · 2026 · PMID 41275879

BACKGROUND: Perioperative chemotherapy is a standard option for treatment of patients with resectable and borderline resectable pancreatic ductal adenocarcinoma (PDAC). This study aimed to assess the superiority of PAXG (cisplatin, nab-paclitaxel, capecitabine, and gemcitabine) over mFOLFIRINOX (modified fluorouracil, leucovorin, irinotecan, and oxaliplatin) in this population. METHODS: CASSANDRA is a randomised, open-label, 2 × 2 factorial phase 3 trial, involving 17 Italian academic hospitals. Eligible patients w…

Modified FOLFIRINOX with or Without Stereotactic Body Radiation in Locally Advanced Unresectable Pancreatic Cancer (SABER): A Randomized Open-Label Phase 2 Trial.

Annals of surgical oncology · 2026 · PMID 42098550

BACKGROUND: Prospective data on stereotactic body radiation therapy (SBRT) combined with modified 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin (mFOLFIRINOX) in patients with locally advanced unresectable pancreatic adenocarcinoma (PDAC) are limited. PATIENTS AND METHODS: The SABER trial was an open-label, randomized, phase 2 study. Patients with locally advanced, unresectable PDAC were eligible if they were suitable for SBRT with adherence to organ-at-risk constraints. Participants were randomized (1:1) …

Maximal Ablative Irradiation Because of Encasement for Patients With Locally Advanced Pancreatic Cancer: A Nonrandomized Clinical Trial.

JAMA surgery · 2026 · PMID 42525419

IMPORTANCE: The best local therapy approach for patients with locally advanced pancreatic cancer (LAPC) remains undefined. OBJECTIVE: To evaluate hypofractionated ablative radiation therapy (A-RT) followed by evaluation for surgery in patients with LAPC whose cancer remained unresectable after induction chemotherapy. DESIGN, SETTING, AND PARTICIPANTS: This was a phase 2 single-arm nonrandomized clinical trial conducted at the Memorial Sloan Kettering Cancer Center, New York, New York, from June 2018 to April 2024. …

Tools and Techniques of Endoscopic Radiofrequency Ablation in Pancreaticobiliary Diseases: A Narrative Review.

Journal of gastrointestinal cancer · 2026 · PMID 42501210

BACKGROUND: Endoscopic radiofrequency ablation (RFA) has become an established minimally invasive option for patients with pancreaticobiliary tumors who are not candidates for resection or who have obstructing lesions of the bile duct or pancreas. This narrative review summarizes the devices, technique, and supporting clinical evidence for endoscopic RFA, organized by clinical indication rather than by device alone. OBJECTIVE: RFA delivers high-frequency alternating current that produces localized thermal injury an…

Tumor Microenvironment Gene Engineering with LOAd703 in Patients with Solid Malignancies: LOKON002 Phase I/IIb Clinical Trial.

Clinical cancer research : an official journal of the American Association for Cancer Research · 2026 · PMID 42053989

PURPOSE: Patients with advanced cancer have a poor prognosis and need for novel treatments. LOAd703 is a tumor microenvironment (TME) gene engineering viral vector encoding genes targeting the CD40 and 4-1BB pathways. In this study, tolerability (primary endpoint), response activity, and the capacity to inflame the TME were evaluated. PATIENTS AND METHODS: In an open-label, single-arm phase I/IIb clinical trial (NCT03225989), a maximum of eight intratumoral injections of LOAd703 were administered biweekly, combined…

Safety and efficacy of fecal microbiota transplantation in solid cancers resistant to immune checkpoint inhibitors: results of the MITRIC trial.

Journal for immunotherapy of cancer · 2026 · PMID 42476727

BACKGROUND: Fecal microbiota transplantation (FMT) has shown promise in overcoming resistance to immune checkpoint inhibitors (ICIs) in early-phase cancer trials. We investigated the safety, feasibility and efficacy of FMT from ICI responders to patients with advanced cancers progressing on ICIs. METHODS: This was a single-arm phase IIa basket trial (MITRIC; NCT05286294) including patients with ICI-refractory cancer. Long-term ICI responders were used as FMT donors. Patients received FMTs in combination with ICIs; …

Efficacy and safety of peptide radionuclide therapy with 177Lu-DOTATATE in Japanese patients with advanced neuroendocrine neoplasm: a multicenter retrospective study (JON2203-N).

Journal of gastroenterology · 2026 · PMID 41866411

BACKGROUND: Peptide receptor radionuclide therapy (PRRT) is an effective treatment for neuroendocrine neoplasms (NENs); however, real-world data in Asia remain limited. METHODS: In this multicenter, nationwide study, we retrospectively analyzed 422 patients with unresectable or recurrent NENs who received 177Lu-DOTATATE-based PRRT at 33 institutions in Japan. Safety analyses were conducted in all enrolled patients and efficacy in 383 patients with complete covariates. RESULTS: The median age was 64 years. The most …

Impact of endoscopic ultrasound-guided fine-needle biopsy on management of suspected small (11-20 mm) and very small (≤10 mm) low-risk nonfunctioning pancreatic neuroendocrine tumors.

Endoscopy · 2026 · PMID 42025206

BACKGROUND: The role of routine endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) of small (≤20 mm) nonfunctioning pancreatic neuroendocrine tumors (NF-PanNETs) remains debated. We evaluated the impact of EUS-FNB on clinical management of very small (≤10 mm) and small (11-20 mm) suspected NF-PanNETs in patients who were otherwise suitable for active surveillance. METHODS: This was a retrospective analysis of patients with single, sporadic, ≤20-mm lesions, exhibiting typical imaging features of NF-PanNET, wh…

Long-term outcomes of endoscopic ultrasound-guided gastroenterostomy: a prospective cohort study tracking symptom recurrence, reintervention timelines, and stent modifications over time.

Gastrointestinal endoscopy · 2026 · PMID 41548724

BACKGROUND AND AIMS: Limited information is available on long-term outcomes of EUS-guided gastroenterostomy (EUS-GE) and modifications of lumen-apposing metal stents (LAMSs) over time. METHODS: All consecutive EUS-GEs for malignant indications between 2020 and 2024 were enrolled in a single-center prospective registry (Prospective Registry of Therapeutic, ClinicalTrials.gov NCT04813055). The primary outcomes were EUS-GE dysfunctions and dysfunction-free survival (DyFS) using Kaplan-Meier curves. Endoscopic and radi…

Mapping the Evidence for Surgical Care of Gastro-Entero-Pancreatic Neuroendocrine Tumors (GEP-NETs): A Scoping Review.

Annals of surgical oncology · 2026 · PMID 42050252

BACKGROUND: Surgical management remains the cornerstone in the management of gastro-entero-pancreatic neuroendocrine tumors (GEP-NETs), yet surgical indications and procedures are often inconsistent. To inform the development of a research agenda to strengthen the evidence in NETs surgical care, we conducted a scoping review to map the existing literature on surgery for gastro-entero-pancreatic (GEP) NETs. MATERIALS AND METHODS: The scoping review was conducted following the expanded framework of Arksey and O'Malle…

Systemic Treatment Followed by Radical Resection Combined With Intestinal Autotransplantation for Locally Advanced Pancreatic Cancer: A Retrospectively Observational and Prospectively Validated Study.

Annals of surgery · 2026 · PMID 39660450

OBJECTIVE: To assess the efficacy of this approach and establish the criteria that identify patients with locally advanced pancreatic cancer (LAPC) who may achieve survival benefits from radical resection combined with intestinal autotransplantation (RRCIA). BACKGROUND: Surgical resection for LAPC remains challenging and is associated with high morbidity and mortality, especially for surgery with major arterial reconstruction. We previously showed the feasibility and safety of RRCIA after systemic treatment. METHOD…

Change in liver fat content in patients following pancreatic resections.

Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026 · PMID 40498287

OBJECTIVES: Metabolic sequelae of pancreatic resections, especially hepatic steatosis, has seldom been studied in detail. This study aims to examine the change in liver fat content following pancreatic resections, specifically pancreaticoduodenectomy, distal pancreatectomy and to identify potential predictors of post-pancreatectomy hepatic steatosis. METHODS: This prospective observational study was conducted from December 2022 to July 2024 and included patients who underwent pancreatic resections at a single terti…

Phase I study of the anti-TIGIT antibody tiragolumab in combination with atezolizumab in Japanese patients with advanced or metastatic solid tumors.

Cancer chemotherapy and pharmacology · 2024 · PMID 38206370

PURPOSE: Tiragolumab is a monoclonal antibody that binds to the inhibitory immune checkpoint TIGIT (T-cell immunoreceptor with Ig and ITIM domains). In early phase clinical trials, tiragolumab in combination with the programmed death-ligand 1-inhibitor atezolizumab was well tolerated and has demonstrated preliminary anti-tumor activity in patients with advanced/metastatic solid tumors. We report the results of a phase I study of tiragolumab plus atezolizumab in Japanese patients (jRCT2080224926). METHODS: Japanese …

Feasibility of a Fully Covered Self-Expandable Metal Stent with a Central Waist and a Long Removal String for Management of Malignant Distal Biliary Obstruction: A Multicenter Prospective Pilot Study.

Journal of clinical medicine · 2026 · PMID 42513526

Background/Objectives: A fully covered self-expandable metal stent (FCSEMS) with a central waist and long retrieval string has recently been introduced for benign biliary strictures; however, its role in malignant biliary obstruction (MBO) remains unclear. This prospective, multicenter study evaluated the feasibility of palliation for unresectable distal MBO. Methods: Between April 2022 and March 2023, patients with extrahepatic MBO were enrolled across six tertiary referral centers. The FCSEMS was a silicone-cover…

Neoadjuvant therapy in frail patients with pancreatic cancer: Impact on surgical safety and outcomes.

Surgery · 2026 · PMID 42114467

BACKGROUND: Frailty predicts poor outcomes after pancreatic resection, but its influence on the use, tolerability, and perioperative safety of neoadjuvant therapy among resected patients remains unclear. METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program pancreatectomy-targeted database (2014-2023), we identified patients undergoing pancreatoduodenectomy or distal pancreatectomy for pancreatic ductal adenocarcinoma. Frailty was defined as a modified 5-factor frailty index …

Cigarette smoking drives earlier development of pancreatic adenocarcinoma among carriers of hereditary pancreatic cancer susceptibility genes.

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · 2026 · PMID 42185193

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) surveillance is recommended for high-risk individuals (HRI) carrying pathogenic variants (PV) in PDAC susceptibility genes or meeting criteria for familial pancreatic cancer (FPC). Cigarette smoking drives earlier PDAC onset in general populations, but this effect is not well-characterized among HRIs. We hypothesized that smoking accelerates the age at PDAC diagnosis for HRIs. METHODS: We identified PDAC patients enrolled in the Pancreatic Adenocarcinoma Gene Envi…

Thoracic Epidural Analgesia Is Not Associated With Improved Survival After Pancreatic Surgery: Long-Term Follow-Up of the Randomized Controlled PAKMAN Trial.

Anesthesia and analgesia · 2025 · PMID 38335141

BACKGROUND: Perioperative thoracic epidural analgesia (EDA) and patient-controlled intravenous analgesia (PCIA) are common forms of analgesia after pancreatic surgery. Current guidelines recommend EDA over PCIA, and evidence suggests that EDA may improve long-term survival after surgery, especially in cancer patients. The aim of this study was to determine whether perioperative EDA is associated with an improved patient prognosis compared to PCIA in pancreatic surgery. METHODS: The PAKMAN trial was an adaptive, pra…

Mistletoe extract in patients with advanced pancreatic cancer: Health-related quality of life in a double-blind, randomized, placebo-controlled trial (MISTRAL).

Palliative medicine · 2026 · PMID 42059487

BACKGROUND: Mistletoe extract is a widespread complementary therapy mainly used for quality-of-life improvement in cancer patients. Advanced pancreatic cancer is associated with poor quality of life and better therapies for symptomatic relief are highly needed. AIM: MISTRAL aimed to assess the impact of mistletoe extract on quality of life, body weight, observed costs and blood biomarkers in patients with advanced pancreatic cancer. DESIGN: MISTRAL was an investigator-initiated, phase III, randomized, double-blind,…

SLOG versus modified FOLFIRINOX as first-line treatment for advanced pancreatic cancer: A randomized phase II trial (TCOG T5217).

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 41576645

OBJECTIVE: A multicenter, randomized phase II trial to compare two first-line triplet treatments for advanced pancreatic ductal adenocarcinoma (PDAC). METHODS: Patients with histologically confirmed advanced PDAC were randomized 1:1 to receive S-1/leucovorin plus oxaliplatin, and gemcitabine (SLOG) or modified FOLFIRINOX (mFOLFIRINOX). Tumor response was assessed every eight weeks. The primary endpoint was progression-free survival (PFS). Secondary endpoints were overall survival (OS), objective response rate (ORR)…

Comparison of clinical/histological outcomes according to puncture sites in endoscopic ultrasound-guided fine needle biopsy for large pancreatic masses: Multicenter randomized prospective pilot study.

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2025 · PMID 39090983

OBJECTIVES: There are no recommendations regarding the optimal puncture site in endoscopic ultrasound-guided fine needle biopsy (EUS-FNB). This multicenter randomized prospective study compared the diagnostic accuracy and histological findings according to the sampling site for pancreatic masses larger than 3 cm. METHODS: Consecutive patients with pancreatic masses larger than 3 cm indicated for EUS-FNB were included in the study. Patients were randomly assigned to two groups for the initial puncture site (central …

Long-term oncological outcomes following algorithm-based care versus usual care for the early recognition and management of complications after pancreatic resection: a post-hoc analysis of a nationwide, stepped-wedge cluster-randomised trial.

The lancet. Gastroenterology & hepatology · 2026 · PMID 41662856

BACKGROUND: Studies have shown that severe postoperative complications after resection of pancreatic and periampullary cancer might have a negative effect on long-term oncological outcomes. The PORSCH trial showed that an algorithm for early recognition and minimally invasive management of complications after pancreatic resection significantly improved short-term clinical outcomes. The algorithm's effect on long-term survival remains to be determined. METHODS: Long-term oncological outcomes were evaluated post hoc …

Effect of Laparoscopic and Open Pancreaticoduodenectomy for Pancreatic or Periampullary Tumors: Three-year Follow-up of a Randomized Clinical Trial.

Annals of surgery · 2024 · PMID 37965767

OBJECTIVE: This study aimed to estimate whether the potential short-term advantages of laparoscopic pancreaticoduodenectomy (LPD) could allow patients to recover in a more timely manner and achieve better long-term survival than with open pancreaticoduodenectomy (OPD) in patients with pancreatic or periampullary tumors. BACKGROUND: LPD has been demonstrated to be feasible and may have several potential advantages over OPD in terms of shorter hospital stay and accelerated recovery than OPD. METHODS: This noninferior…

Somatostatin Versus Octreotide for Prevention of Postoperative Pancreatic Fistula: The PREFIPS Randomized Clinical Trial: A FRENCH 007-ACHBT Study.

Annals of surgery · 2024 · PMID 38662619

OBJECTIVE: Pharmacological prevention of postoperative pancreatic fistula (POPF) after pancreatectomy is open to debate. The present study compares clinically significant POPF rates in patients randomized between somatostatin versus octreotide as prophylactic treatment. METHODS: Multicentric randomized controlled open study in patient's candidate for pancreaticoduodenectomy (PD) or distal pancreatectomy (DP) comparing somatostatin continuous intravenous infusion for 7 days versus octreotid 100 μg, every 8 hours sub…

Modified Fluorouracil, Leucovorin, Irinotecan, and Oxaliplatin or S-1, Irinotecan, and Oxaliplatin Versus Nab-Paclitaxel + Gemcitabine in Metastatic or Recurrent Pancreatic Cancer (GENERATE, JCOG1611): A Randomized, Open-Label, Phase II/III Trial.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025 · PMID 40720715

PURPOSE: Modified fluorouracil, leucovorin, irinotecan, and oxaliplatin (mFOLFIRINOX) and nab-paclitaxel + gemcitabine are recommended as first-line treatments for metastatic pancreatic cancer. S-1, irinotecan, and oxaliplatin (S-IROX) demonstrated activity in a phase Ib trial in this population. Therefore, these three regimens were directly compared. METHODS: This randomized phase II/III trial was performed at 45 centers in Japan. Eligible patients age 20-75 years with an Eastern Cooperative Oncology Group perform…

Video Education Is an Acceptable Alternative to Pretest Genetic Counseling for Patients With Breast, Ovarian, Pancreatic, and Metastatic Prostate Cancer: Results From a Randomized Study.

JCO oncology practice · 2025 · PMID 40209136

PURPOSE: With increased demand for cancer genetic testing (GT), providers are exploring alternative service delivery models such as video education (VE). We compare the uptake of GT among 250 patients with breast, ovarian, pancreatic, or metastatic prostate cancer randomly assigned to receive either pretest VE or a pretest visit with a genetic counselor (GC). MATERIALS AND METHODS: Using a 3:1 ratio, 187 patients were randomly assigned to the VE arm and 63 patients to the GC arm. GT was arranged after participants …

Comparation of 5 ml and 10 ml Negative Pressures with Wet-suction Techniques for EUS-FNA of Solid Lesions: A Single-center Randomized Controlled Trial.

Journal of clinical gastroenterology · 2025 · PMID 38359147

BACKGROUND AND OBJECTIVES: The negative pressure selectable for the wet-suction technique remains uncertain. The aim was to investigate the quality of sampling and diagnostic accuracy with solid lesions by 5 mL and 10 mL negative pressure with wet-suction techniques. METHODS: This is a single-center, crossover, randomized controlled trial conducted with a random sampling technique. In all, 160 patients consecutively undergoing EUS-FNA for solid lesions were randomized in a ratio of 1:1 into 2 groups, the 5 mL and 1…

Outcome following pylorus resecting pancreaticoduodenectomy versus classical Whipple's pancreaticoduodenectomy: a randomised controlled trial.

HPB : the official journal of the International Hepato Pancreato Biliary Association · 2025 · PMID 39757070

OBJECTIVE: To compare pylorus resecting pancreaticoduodenectomy (PRPD) with classical pancreaticoduodenectomy (classical PD) in terms of short term outcomes. BACKGROUND: There is some evidence that Pylorus resecting PD (PRPD) is associated with lesser incidence of DGE when compared to pylorus preserving PD (PPPD). However, no study has previously compared PRPD with classical PD. METHODS: Patients requiring PD were randomly assigned to either PRPD or classical PD after intraoperative assessment to rule out metastase…

Early tumor shrinkage as a prognostic predictor in chemotherapy-naïve patients with locally advanced pancreatic cancer treated with modified FOLFIRINOX or gemcitabine plus nab-paclitaxel combination therapy: An exploratory analysis of JCOG1407.

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · 2024 · PMID 39060124

BACKGROUND: Early tumor shrinkage (ETS) is a prognostic predictor for patients treated with chemotherapy in colorectal cancer, although scarce studies evaluated its potential in locally advanced pancreatic cancer (LAPC). In this exploratory analysis of JCOG1407, a randomized phase II study comparing modified 5-fluorouracil, levofolinate, irinotecan, and oxaliplatin (mFOLFIRINOX) and gemcitabine plus nab-paclitaxel (GnP), we evaluated whether ETS can predict prognosis of patients with LAPC. METHODS: Of the 126 patie…

A Randomized Trial of Nutrition and Exercise Treatment in Patients With Pancreatic and Non-Small Cell Lung Cancer (NEXTAC-TWO).

Journal of cachexia, sarcopenia and muscle · 2025 · PMID 40522817

BACKGROUND: In our previous study (NEXTAC-ONE), the Nutrition and Exercise Treatment for Advanced Cancer (NEXTAC) program (including home-based exercise and branched-chain amino acid-containing supplements combined with nutritional counselling) was shown to potentially prevent low muscle mass-related disability in elderly cancer patients. This randomized controlled trial (NEXTAC-TWO) was conducted to elucidate whether the NEXTAC program prolongs disability-free survival in elderly patients with advanced pancreatic …

Trajectories of perioperative nutritional status in patients with pancreatic tumor after surgery in six months.

European journal of oncology nursing : the official journal of European Oncology Nursing Society · 2024 · PMID 39288676

PURPOSE: To characterize subgroups with similar nutritional status trajectories during the 6-month period after pancreatectomy and to identify demographic and clinical characteristics influencing changes in nutritional status in each subgroup. METHODS: This longitudinal prospective study recruited 112 patients with newly diagnosed pancreatic tumor from an outpatient pancreatic surgical department of a medical center in northern Taiwan between September 2016 and April 2019. Patients completed a demographic and clini…

Effects of the superior mesenteric artery approach versus the no-touch approach during pancreatoduodenectomy on the mobilization of circulating tumour cells and clusters in pancreatic cancer (CETUPANC): randomized clinical trial.

BJS open · 2024 · PMID 39485887

BACKGROUND: Patients with pancreatic ductal adenocarcinoma present early postoperative systemic metastases, despite complete oncological resection. The aim of this study was to assess two pancreatoduodenectomy approaches with regard to intraoperative circulating tumour cells and cluster mobilization and their potential association with the development of distant metastasis. METHODS: Patients with periampullary tumours who underwent open pancreatoduodenectomy were randomly allocated to either the no-touch approach o…

Sequential nutrition intervention guided by nutritional risk screening improves outcomes following CyberKnife radiotherapy for pancreatic cancer: A randomized controlled trial.

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · 2025 · PMID 40783360

INTRODUCTION: Nutritional status may determine the outcomes of patients with pancreatic cancer. This study aimed to investigate the value of sequential nutrition intervention guided by nutritional risk screening for patients undergoing CyberKnife radiotherapy for pancreatic cancer. METHODS: A total of 100 patients with pancreatic cancer were enrolled and randomly divided into a control group (n = 50) and a nutrition intervention group (n = 50). Nutritional status, immunity, QoL, and postoperative complications were…

MRI-guided stereotactic ablative body radiotherapy versus CT-guided percutaneous irreversible electroporation for locally advanced pancreatic cancer (CROSSFIRE): a single-centre, open-label, randomised phase 2 trial.

The lancet. Gastroenterology & hepatology · 2024 · PMID 38513683

BACKGROUND: Pancreatic ductal adenocarcinoma is an aggressive disease with a dismal prognosis. Stage III locally advanced pancreatic cancer is considered unresectable and current palliative chemotherapy regimens only modestly improve survival. Guidelines suggest chemoradiation or stereotactic ablative body radiotherapy (SABR) could be beneficial in certain circumstances. Other local treatments such as irreversible electroporation could enhance patient outcomes by extending survival while preserving quality of life.…

Long-term outcomes of prophylactic right-half dissection of the superior mesenteric artery nerve plexus in pancreatoduodenectomy for pancreatic ductal adenocarcinoma: five-year results from a randomized phase II trial.

Surgery today · 2025 · PMID 40380996

PURPOSES: In pancreaticoduodenectomy for pancreatic ductal adenocarcinoma (PDAC), Prophylactic right-half dissection of the superior mesenteric artery (SMA) nerve plexus has been attempted in pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. In this study, we evaluated the significance of prophylactic right-half dissection of the SMA nerve plexus by extending the observation period to 5 years. METHODS: From April 2014 to June 2018, 74 patients with PDAC in the pancreatic head were randomly assigned to e…

A Randomized Controlled Trial of Mindfulness Meditation Combined With BrainLink Intelligent Biofeedback Instrument on Pancreatic Cancer Patients Under Chemotherapy.

Brain and behavior · 2024 · PMID 39711061

BACKGROUND: Adjuvant chemotherapy can promote the 5-year overall survival rate of pancreatic cancer (PC) patients to 16%-21%. However, the negative emotions of patients, such as anxiety, are usually omitted. Moreover, their disease burden concentrates on pain symptoms, seriously affecting the quality of life of patients. How to improve the negative emotions of PC patients, alleviate their pain, and ameliorate their quality of life has become an urgent issue. OBJECTIVE: To explore the effect of mindfulness meditatio…

Digital subtraction angiography-guided pancreatic arterial infusion of GEMOX chemotherapy in advanced pancreatic adenocarcinoma: a phase II, open-label, randomized controlled trial comparing with intravenous chemotherapy.

BMC cancer · 2024 · PMID 39095759

BACKGROUND: Advanced pancreatic adenocarcinoma lacks effective treatment options, and systemic gemcitabine-based chemotherapy offers only marginal survival benefits at the cost of significant toxicities and adverse events. New therapeutic options with better drug availability are warranted. This study aims to evaluate the safety and efficacy of digital subtraction angiography (DSA)-guided pancreatic arterial infusion (PAI) versus intravenous chemotherapy (IVC) using the gemcitabine and oxaliplatin (GEMOX) regimen i…

Endoscopic ultrasound (EUS) elastography-guided fine-needle aspiration cytology (FNAC) versus conventional EUS FNAC for solid pancreatic lesions: A pilot randomized trial.

Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2025 · PMID 39230660

BACKGROUND: Endoscopic ultrasound guided fine-needle aspiration (EUS FNA) is the first-line modality to diagnose suspected solid pancreatic malignant lesions. Elastography-guided FNA has been shown to improve the diagnostic yield of EUS FNA but prospective studies are limited. The aim of the study was to compare diagnostic accuracy, sensitivity and specificity of conventional and elastography-guided EUS FNA in patients with suspected malignant pancreatic solid masses. METHODS: Patients with suspected malignant soli…

Splanchnic nerve block via transdiscal and paraspinal approach in the treatment of pain in advanced pancreatic cancer: A randomized controlled trial.

Medicine · 2025 · PMID 40988238

BACKGROUND: This randomized controlled clinical trial aims to assess the clinical effect of splanchnic nerve block through transdiscal and paraspinal approaches in treating pain from advanced pancreatic cancer. METHODS: Patients with progressive pancreatic cancer pain who were treated in the Pain Department of the First Affiliated Hospital of Nanchang University from December 2021 to March 2023 were selected. According to the inclusion and exclusion criteria, 34 patients were randomly divided into a transdiscal gro…

Contrast-enhanced endoscopic ultrasound versus conventional endoscopic ultrasound-guided fine-needle biopsy with macroscopic on-site evaluation for solid pancreatic lesions: a multicenter randomized trial.

Gastrointestinal endoscopy · 2026 · PMID 41135907

BACKGROUND AND AIMS: Although contrast-enhanced EUS (CE-EUS) has been suggested to improve the diagnostic yield of EUS-guided fine-needle aspiration (FNA) of solid pancreatic lesions (SPLs), multicenter data to inform its use in fine-needle biopsy (FNB) remain scarce. This multicenter randomized trial aims to compare the diagnostic performance of CE-EUS and conventional EUS-guided FNB with macroscopic on-site evaluation (MOSE) for SPLs. METHODS: Consecutive patients with SPLs ≥1 cm from 3 referral centers (Hong Kon…

Randomized trial comparing the Franseen needle versus 2 types of sharpened-tip 3-prong needles in EUS-guided tissue acquisition from solid pancreatic lesions.

Gastrointestinal endoscopy · 2025 · PMID 40120866

BACKGROUND AND AIMS: EUS-guided tissue acquisition (EUS-TA) is crucial for diagnosing pancreatic diseases. Recently, 2 novel types of sharpened-tip, 3-prong fine-needle biopsy (FNB) needles, the Trident needle (Micro-Tech Endoscopy, High Wycombe, UK) and the 3-point needle (TopGain; MediGlobe, London, UK), were developed to improve puncture performance. In this study, these novel needles were compared with the conventional Franseen needle in EUS-TA from solid pancreatic lesions (SPLs). METHODS: In this prospective,…

Blumgart Anastomosis Versus Invaginating Pancreatogastrostomy for Reconstruction after Pancreatoduodenectomy: A Randomized Controlled Trial.

Annals of surgery · 2025 · PMID 40747945

OBJECTIVE: To compare postoperative pancreatic fistula (POPF) rates between Blumgart anastomosis (BA) and invaginating pancreatogastrostomy (PG) after pancreatoduodenectomy (PD). BACKGROUND: POPF rates after PD are still high. The only modifiable factor available to improve POPF is the anastomotic technique. BA and PG anastomoses have been previously shown to be feasible and safe, but they have never been compared in a randomized trial. METHODS: A multicenter, randomized, controlled trial was conducted in 13 Univer…