Pancreatic Cancer

UGT1A1 genotype testing for irinotecan: A guideline developed by the UK Centre of Excellence in Regulatory Science and Innovation in Pharmacogenomics (CERSI-PGx).

British journal of clinical pharmacology · 2026 · PMID 42389808

Irinotecan, a topoisomerase I inhibitor, is available as both non-pegylated and pegylated formulations. The non-pegylated formulation is licensed for use in advanced colorectal cancer either in combination with other agents or as monotherapy. However, it is also used off-label across a range of gastrointestinal malignancies and in rare malignancies such as glioblastoma and sarcomas. The pegylated formulation is licensed for use as combination therapy in adult patients with metastatic pancreatic adenocarcinoma. Irin…

Pancreatic cystic lesions: position paper of the SIRM-AISP multidisciplinary group.

La Radiologia medica · 2026 · PMID 42340659

Pancreatic cystic lesions represent an increasingly common clinical finding due to the widespread use of cross sectional imaging, encompassing a heterogeneous spectrum ranging from benign entities to premalignant and malignant neoplasms. Their rising incidence poses significant challenges in diagnosis, risk stratification, and management, requiring a careful balance between avoiding unnecessary interventions and preventing malignant progression. This position paper, developed by an intersocietal multidisciplinary p…

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, (…

Danish Pancreatic Cancer Group consensus guidelines on the management of pancreatic IPMN.

Acta radiologica (Stockholm, Sweden : 1987) · 2026 · PMID 42678719

BackgroundIntraductal papillary mucinous neoplasms (IPMNs) are the most common pancreatic cystic neoplasms and are increasingly detected incidentally. Although they carry malignant potential, most lesions follow an indolent course, creating a clinical challenge in balancing early cancer detection with the risks of overtreatment. Existing international guidelines differ in surveillance strategies, thresholds for intervention, and recommendations for discontinuation.PurposeTo present Danish multidisciplinary consensu…

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…

Pancreatic Adenocarcinoma, Version 4.2026, NCCN Clinical Practice Guidelines In Oncology.

Journal of the National Comprehensive Cancer Network : JNCCN · 2026 · PMID 42869082

The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Pancreatic Adenocarcinoma provide multidisciplinary diagnostic workup, staging, and treatment recommendations for resectable, borderline resectable, unresectable, locally advanced, and metastatic disease. This article summarizes the studies and Panel discussion that serve as the rationale for comprehensive care recommendations included in the NCCN Guidelines for Pancreatic Adenocarcinoma.

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 …

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…

European Standard Clinical Practice Guideline and EXPeRT Recommendations for the Diagnosis and Management of Gastroenteropancreatic Neuroendocrine Neoplasms in Children and Adolescents.

Pediatric blood & cancer · 2026 · PMID 41834272

Pediatric gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are extremely rare and clinically heterogeneous. Management has largely been extrapolated from adult practice. This European Standard Clinical Practice Guideline (ESCP), developed by the EXPeRT network in collaboration with adult NEN experts, provides (adult) evidence-informed and consensus-driven recommendations. Using a literature review and GRADE methodology, we address clinical evaluation, imaging pathology, genetics, surgical and systemic the…

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 …

International consensus on mesopancreas and total mesopancreas excision (MESODELPHI).

HPB : the official journal of the International Hepato Pancreato Biliary Association · 2026 · PMID 42436071

BACKGROUND: The absence of a standardized anatomical definition of the mesopancreas has precluded meaningful comparison across studies on total mesopancreas excision (TMpE). The MESODELPHI consensus aimed to establish international agreement on its definition, surgical boundaries, and clinical role in pancreatic cancer management. METHODS: An international modified Delphi process, informed by a prior systematic review, included 43 pancreatic surgery experts from 20 countries across two rounds. Statements were rated…

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 …

Recommendations for selection, treatment, and follow-up in peptide receptor radionuclide therapy (PRRT) for neuroendocrine tumors: a Delphi consensus from the Galician Multidisciplinary Group on Neuroendocrine and Endocrine Tumors (GGNET).

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026 · PMID 41806239

BACKGROUND: Peptide receptor radionuclide therapy (PRRT) is an established treatment for patients with well-differentiated gastroenteropancreatic neuroendocrine tumors (GEP-NETs) expressing somatostatin receptors (SSTR). Despite robust trial and real-world data, heterogeneity persists regarding patient selection, therapeutic sequencing, and follow-up strategies. METHODS: A Delphi consensus was conducted by the Galician Multidisciplinary Group on Neuroendocrine and Endocrine Tumors (GGNET). Ten experts in oncology, …

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…

The Concept of Biological Resectability in Pancreatic Ductal Adenocarcinoma - An Updated Narrative Review.

Annali italiani di chirurgia · 2026 · PMID 42610296

Resectability in pancreatic ductal adenocarcinoma (PDAC) has traditionally been defined according to tumor-vessel relationship on cross-sectional imaging. However, anatomical criteria alone fail to identify occult systemic disease and do not reliably predict early postoperative recurrence or the likelihood of meaningful oncological benefit from surgery. This structured narrative review evaluated contemporary evidence regarding biological resectability and the emerging role of biomarkers in perioperative decision-ma…

Impact of learning phase on complications and oncological quality in robotic left-sided pancreatectomy: A multicenter international analysis.

Surgery · 2026 · PMID 42361532

BACKGROUND: Robotic left-sided pancreatectomy is increasingly adopted worldwide, yet the impact of the learning curve on clinical and oncological outcomes remains unclear. The Brescia consensus defines the first 21 cases as the competency phase, but real-world validation is limited. We evaluated whether the surgical learning phase influenced major morbidity and oncological quality following robotic left-sided pancreatectomy. METHODS: This multicenter retrospective cohort study included consecutive patients undergoi…

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…

Impact of GLP-1 receptor agonists on patients with intraductal papillary mucinous neoplasms: Study protocol for a multicentric cohort study.

PloS one · 2026 · PMID 42715243

AIM OF THE STUDY: Intraductal papillary mucinous neoplasms (IPMNs) are among the most common cystic pancreatic neoplasms, with a potential to progress to malignancy. The increasing prevalence of IPMNs, coupled with the widespread use of GLP-1 receptor agonists (GLP-1 RAs) for diabetes and obesity management, raises concerns about the safety of these medications in patients with preexisting pancreatic conditions. Despite their proven metabolic benefits, questions remain about their impact on pancreatic pathology. Th…

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…

Clinical Impact of Endoscopic Ultrasound-Guided Fine-Needle Biopsy in Radiologically Suspected Pancreatic Neuroendocrine Tumors.

Journal of digestive diseases · 2026 · PMID 42687717

OBJECTIVES: Incidental diagnosis of pancreatic neuroendocrine tumors (PNETs) is increasing. Its surgical indication depends on the risk of progression, whereas histological features can be assessed by endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB). However, its systematic use remains a matter of debate. We aimed to analyze the impact of EUS-FNB on therapeutic management in patients with radiologically suspected PNETs. METHODS: In this retrospective observational single-center study, all patients with sus…

Quantitative MRI of pancreatic parenchyma in intraductal papillary mucinous neoplasm: association with risk stratification based on guideline features.

European radiology · 2026 · PMID 42209832

OBJECTIVES: To investigate the association between quantitative MRI parameters of the pancreatic parenchyma and risk stratification of intraductal papillary mucinous neoplasm (IPMN). MATERIALS AND METHODS: This study included 235 participants: 163 with IPMN and 72 with a normal pancreas. IPMN cases were stratified into IPMN without guideline-based features (n = 111) and with guideline-based features (n = 52) groups based on the 2024 International Consensus Guidelines. The MRI parameters analyzed included pancreas-t…

Global Perspectives on Radiotherapy Utilization for Pancreatic Ductal Adenocarcinoma.

Journal of gastrointestinal cancer · 2026 · PMID 42791432

PURPOSE: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy requiring multi-modality treatment. Radiotherapy (RT) may improve local control and resection rates, though evidence to support use across various stages of disease is mixed and evolving. This study sought to investigate international practice patterns and provider preferences for the use of radiotherapy in the multidisciplinary management of PDAC. METHODS: A 39-item electronic survey was distributed in 2025 through three sub-specialty org…

Stakeholder Consensus Selection of Data Elements and Indicators for a Pancreatic Cancer Surgical Outcomes Registry in Australia and Aotearoa New Zealand: Modified Delphi Process.

ANZ journal of surgery · 2026 · PMID 42274276

BACKGROUND: The data elements and indicators in a clinical quality registry (CQR) contribute towards the utility of its output and should be informed by stakeholder input. In Australia and Aotearoa New Zealand (AANZ), there is no CQR for pancreatic cancer surgery. This study aimed to select data elements and registry aims with stakeholder input. METHODS: A three-round modified Delphi consensus process was conducted involving clinicians and consumers. An initial list of data elements was generated through a review o…

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…

Beyond predictive performance: A systematic review and critical methodological appraisal of AI/ML and conventional modelling strategies in breast, colorectal, and pancreatic Cancer.

Artificial intelligence in medicine · 2026 · PMID 42641254

BACKGROUND: Predictive modelling for cancer risk, treatment-related complications, and survival is central to precision oncology. Conventional logistic regression (LR) and Cox proportional hazards (CoxPH) regression remain widely used but are limited when modelling nonlinear interactions, high-dimensional imaging features, and multimodal clinical-metabolic predictors. Artificial intelligence (AI) and machine learning (ML) methods offer expanded capability through automated feature extraction, ensemble learning, and…

AGA Clinical Practice Update on Surveillance of Pancreatic Cystic Lesions and Hepatocellular Carcinoma in Older Adults: Expert Review.

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026 · PMID 42820904

DESCRIPTION: There is a demographic explosion of patients over the age of 60 expected in the United States and worldwide in the next 20 years. Pancreatic cystic lesions (PCLs) are frequently, incidentally identified in more than a quarter of patients above the age of 70 and while the vast majority of these lesions are indolent, some may develop into malignancy. Similarly, while the risk of hepatocellular carcinoma (HCC) is well established in patients with cirrhosis, the proportion of the elderly population with ci…

Danish Pancreatic Cancer Group consensus guidelines on the management of pancreatic IPMN.

Acta radiologica (Stockholm, Sweden : 1987) · 2026 · PMID 42678719

BackgroundIntraductal papillary mucinous neoplasms (IPMNs) are the most common pancreatic cystic neoplasms and are increasingly detected incidentally. Although they carry malignant potential, most lesions follow an indolent course, creating a clinical challenge in balancing early cancer detection with the risks of overtreatment. Existing international guidelines differ in surveillance strategies, thresholds for intervention, and recommendations for discontinuation.PurposeTo present Danish multidisciplinary consensu…

Pancreatic cystic lesions: position paper of the SIRM-AISP multidisciplinary group.

La Radiologia medica · 2026 · PMID 42340659

Pancreatic cystic lesions represent an increasingly common clinical finding due to the widespread use of cross sectional imaging, encompassing a heterogeneous spectrum ranging from benign entities to premalignant and malignant neoplasms. Their rising incidence poses significant challenges in diagnosis, risk stratification, and management, requiring a careful balance between avoiding unnecessary interventions and preventing malignant progression. This position paper, developed by an intersocietal multidisciplinary p…

Prognostic and predictive values of transcriptomic signatures in metastatic pancreatic cancer: A biomarker analysis of three French multicenter prospective randomized controlled phase 2 trials (Prodige35, Prodige37 and AFUGEM).

Cancer letters · 2026 · PMID 42521075

To evaluate the clinical applicability of previously established transcriptomic signatures (molecular subtypes, components and GemPred status) in metastatic pancreatic cancer, we conducted a retrospective pooled analysis of 178 patients from three phase 2 trials (PRODIGE35/37, AFUGEM; 2013-2016) testing first-line regimens (FOLFIRINOX, GemNab, FuNab, FOLFIRI3). RNA sequencing was performed on primary/metastatic tumors across French centers, with blinded assessment of subtypes (immune classical, pure basal-like, str…

Systemic immune-inflammation index as a prognostic marker in pancreatic ductal adenocarcinoma: a metaanalysis.

Cancer treatment and research communications · 2026 · PMID 42485687

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal malignancy with limited durable treatment options despite evolving multimodal and systemic strategies. Systemic inflammation has emerged as a clinically relevant determinant of outcomes in several cancers. The systemic immune-inflammation index (SII; platelet count x neutrophil count / lymphocyte count) integrates key circulating immune cell populations and may serve as an accessible prognostic biomarker in PDAC. METHODS: A systematic search of …

NALIRIFOX versus FOLFIRINOX: reconstructed individual patient data meta-analysis of efficacy and safety in first-line treatment of unresectable or metastatic pancreatic ductal adenocarcinoma.

Frontiers in oncology · 2026 · PMID 42827581

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal human malignancies, with a 5-year overall survival rate below 10%. NALIRIFOX and FOLFIRINOX, both in full-dose and modified (mFOLFIRINOX) formulations, are guideline-endorsed Category 1 first-line regimens for fit patients with metastatic PDAC. However, no direct head-to-head randomized trial has compared these regimens. This systematic review and reconstructed individual patient data meta-analysis represents the first comprehensive …

Value addition by subspecialty trained radiologists in multidisciplinary tumor boards for pancreatic adenocarcinoma: a systematic review and meta-analysis.

La Radiologia medica · 2026 · PMID 41166033

OBJECTIVE: To perform a systematic review assessing the role of subspecialty radiologist in a multidisciplinary team (MDT) focused on pancreatic adenocarcinoma (PDAC) and the impact on patient outcomes. METHODS AND MATERIALS: Ovid MEDLINE, Ovid Embase, Cochrane Database of Systematic Reviews (Ovid), Cochrane Central Register of Controlled Trials (Ovid), and Web of Science searched until August 31, 2023, for studies including radiology review in PDAC MDT. Data extraction, risk of bias, and applicability assessment w…

Prognostic value of albumin-bilirubin grade in patients with pancreatic cancer: A systematic review and meta-analysis.

Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026 · PMID 41795748

BACKGROUND: With a five-year survival rate near 10%, pancreatic cancer is among the cancers with poor survival. Understanding the prognostic factors provides clinical insights for better decision-making. This meta-analysis aims to assess the prognostic value of the albumin-bilirubin (ALBI) grade in patients with pancreatic cancer. METHOD: A comprehensive search using "pancreatic cancer" and "ALBI grade" as keywords was conducted on the PubMed, Web of Science, Embase and Scopus until August 14, 2025. Studies investi…

Predicting the unpredictable: prognostic and predictive power of FAPI-PET imaging in oncology: a systematic review and meta-analysis.

European journal of nuclear medicine and molecular imaging · 2026 · PMID 41588207

OBJECTIVES: In this systematic review, we evaluated the accuracy of baseline fibroblast activation protein inhibitor (FAPI)-based PET scans for predicting overall survival (OS), progression-free survival (PFS), and tumor response after treatment completion. METHODS: We searched PubMed and Cochrane Library until August 2025 to identify studies that evaluated the prognostic and predictive value of FAPI-based PET scans parameters in the OS, PFS, and treatment response of cancer patients; all studies reporting these fi…

Oral and Pancreatobiliary Microbiota in Cancer: A Systematic Review of Compositional Alterations and Their Clinical Implications.

Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology · 2026 · PMID 42477955

BACKGROUND: Associations between microbial dysbiosis and malignancies of the pancreatobiliary system have been described in recent studies. As a result of the limited number of studies that have been done specifically on the malignancies of the biliary tract, information regarding oral, biliary and tumour-related microbial alterations was combined to provide an overview of the microbial changes that may occur. METHODS: Studies that involved observations on the composition or presence of dysbiosis of the microbiota …

The prognostic value of CLDN18.2 expression in pancreatic ductal adenocarcinoma: a systematic review and individual patient data meta-analysis.

Virchows Archiv : an international journal of pathology · 2026 · PMID 41091169

Pancreatic ductal adenocarcinoma (PDAC) is the most common malignant tumor of the exocrine pancreas. Due to the limited treatment options currently available and the challenges in timely and accurate screening, most patients experience rapid disease progression following initial diagnosis. CLDN18.2, an isoform of claudin-18, is normally expressed in gastric tissues but can be ectopically expressed in PDAC. This biomarker remains underexplored in the context of PDAC, and its association with patient prognosis is not…

Deep learning models for pancreatic cancer detection on CT: a meta-analysis.

Frontiers in medicine · 2026 · PMID 42807151

This systematic review and meta-analysis evaluates the diagnostic accuracy of deep learning models for detecting pancreatic ductal adenocarcinoma using computed tomography scans. A systematic literature search of PubMed, Web of Science, and the Cochrane Library was conducted for studies published up to September 11, 2025. Study screening and data extraction were performed independently by two reviewers. Studies utilizing deep learning models for pancreatic ductal adenocarcinoma detection on computed tomography, wit…

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…

What Are Computer-Assisted Methods Achieving in Fine-Needle Aspiration Cytology of the Pancreas? A Systematic Review and Meta-Analysis.

Cytopathology : official journal of the British Society for Clinical Cytology · 2026 · PMID 42192263

OBJECTIVE: Pancreatic malignancies present major diagnostic challenges. The gold standard for diagnosis is endoscopic ultrasound-guided fine-needle aspiration (FNA) with cytopathological assessment. Workforce shortages have driven interest in computer-assisted diagnosis (CAD) to improve efficiency. However, its overall diagnostic impact in pancreatic cytology remains unclear. We evaluated the accuracy of CAD in this setting. METHODS: We conducted a systematic review and meta-analysis. Five databases were searched (…

Noninvasive microbiota-based diagnostic models for pancreatic ductal adenocarcinoma: a systematic review and diagnostic test accuracy meta-analysis.

Frontiers in microbiology · 2026 · PMID 42846530

BACKGROUND: Due to delays in diagnosis, many patients with pancreatic ductal adenocarcinoma (PDAC) miss the window for curative interventions. The oral and gut microbiomes are attractive as noninvasive triage instruments; however, while the literature provides AUROC values, it has not established clinically useful thresholds. OBJECTIVE: To systematically assess the diagnostic performance and clinical maturity of noninvasive microbiota-derived tools for identifying PDAC. METHODS: Following PRISMA 2020 and PRISMA-DTA…

MRI and PET-Based Machine Learning Radiomics for Metastasis Prediction in Pancreatic Ductal Adenocarcinoma: A Systematic Review.

Journal of gastrointestinal cancer · 2025 · PMID 41428015

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy with poor survival, driven in part by early metastatic spread. Conventional imaging lacks sufficient precision to predict metastasis accurately. Machine learning (ML)-based radiomics, integrating quantitative imaging features from modalities such as magnetic resonance imaging (MRI) and positron emission tomography (PET), may enhance prognostic accuracy. OBJECTIVE: To systematically review the diagnostic accuracy and clinical utility of …

Vertical distribution of accessory canals in different tooth types: A systematic review and meta-analysis.

Journal of dentistry · 2026 · PMID 42492648

OBJECTIVE: To systematically analyze the vertical distribution of accessory canals and propose potential root-end resection levels in different tooth types. DATA: Proportional distribution of accessory canals (PD-AC) in 1 mm intervals, cumulative proportions within 2 mm and 3 mm (CP-AC0-2 and CP-AC0-3), mean distance from accessory foramen to root apex or main foramen (MD-AF), and prevalence of accessory canals in 2D cross-sections (PR-AC-2D). SOURCES: A systematic search of electronic databases was conducted throu…

Endoscopic Ultrasound-Guided Franseen Fine-Needle Biopsy for Solid Pancreatic Lesions: A Systematic Review and Meta-Analysis.

Digestive diseases and sciences · 2026 · PMID 42156629

INTRODUCTION: Accurate tissue acquisition (TA) of solid pancreatic lesions is essential for guiding treatment with endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) being the preferred method. Among FNB designs, the three-pronged Franseen-tip needle demonstrates strong diagnostic performance, though direct head-to-head comparisons with other FNB designs remain limited. METHODOLOGY: This meta-analysis was conducted in accordance with PRISMA guidelines (PROSPERO: CRD420251123856). Eligible studies enrolled pa…

Comparing Endoscopic Ultrasound (EUS) vs. Magnetic Resonance Cholangiopancreatography (MRCP) in the Etiological Evaluation of Idiopathic Acute Pancreatitis (IAP): A Systematic Review and Meta-Analysis.

Digestive diseases and sciences · 2026 · PMID 41015654

INTRODUCTION: Idiopathic acute pancreatitis (IAP) accounts for up to 20% of acute pancreatitis cases despite thorough initial evaluation. Endoscopic ultrasound (EUS) and magnetic resonance cholangiopancreatography (MRCP) are commonly used as second-line imaging modalities when IAP etiologies are unclear, yet their comparative diagnostic performance remains uncertain. We conducted a systematic review and meta-analysis to assess the diagnostic yield of EUS versus MRCP in identifying etiologies of IAP. METHODS: A syst…

Value of 3D reconstructions in pancreatic surgery: Current status.

Journal of visceral surgery · 2026 · PMID 41125479

INTRODUCTION: Three-dimensional (3D) reconstruction transforms cross-sectional medical images into interactive anatomical models, interpretable on an LCD screen, in augmented reality or via 3D printing. Although certain benefits have been established in liver surgery, its use in pancreatic surgery remains limited. This update outlines the applications of 3D visualization in pancreatic surgery, ranging from surgical planning to teaching. METHOD: A systematic search for English-language articles reporting 3D pancreat…

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…

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 …

Imaging-based diagnosis of pancreatic cancer: a systematic review and meta-analysis of direct comparative studies.

European radiology · 2026 · PMID 42821086

OBJECTIVES: Pancreatic ductal adenocarcinoma (PDAC) is a fast-evolving malignancy, with resection being the only chance of cure. We aim to determine which imaging technique provides the best diagnostic performance in detecting and assessing the spread of PDAC. MATERIALS AND METHODS: Our study was registered on PROSPERO (CRD42024567008). On July 9, 2024, a systematic search was conducted in three databases, focusing on direct comparative studies that reported on patients suspected of PDAC who underwent at least two …

Sweetened Beverages and Pancreatic Cancer: Insights From Recent Epidemiological Data and Oncogenic Mechanisms.

Molecular nutrition & food research · 2026 · PMID 42806724

PURPOSE OF REVIEW: Hyperglycemia and altered carbohydrate metabolism may promote pancreatic cancer cell survival and proliferation. This narrative review critically evaluates epidemiological evidence on whether sugar-sweetened beverage (SSB) consumption is associated with pancreatic cancer risk and examines potential biological mechanisms involving glucose and fructose metabolism, oncogenic KRAS signaling, and metabolic reprogramming. RECENT FINDINGS: Earlier pooled analyses and a 2019 meta-analysis found no signif…

Beyond predictive performance: A systematic review and critical methodological appraisal of AI/ML and conventional modelling strategies in breast, colorectal, and pancreatic Cancer.

Artificial intelligence in medicine · 2026 · PMID 42641254

BACKGROUND: Predictive modelling for cancer risk, treatment-related complications, and survival is central to precision oncology. Conventional logistic regression (LR) and Cox proportional hazards (CoxPH) regression remain widely used but are limited when modelling nonlinear interactions, high-dimensional imaging features, and multimodal clinical-metabolic predictors. Artificial intelligence (AI) and machine learning (ML) methods offer expanded capability through automated feature extraction, ensemble learning, and…

UGT1A1 genotype testing for irinotecan: A guideline developed by the UK Centre of Excellence in Regulatory Science and Innovation in Pharmacogenomics (CERSI-PGx).

British journal of clinical pharmacology · 2026 · PMID 42389808

Irinotecan, a topoisomerase I inhibitor, is available as both non-pegylated and pegylated formulations. The non-pegylated formulation is licensed for use in advanced colorectal cancer either in combination with other agents or as monotherapy. However, it is also used off-label across a range of gastrointestinal malignancies and in rare malignancies such as glioblastoma and sarcomas. The pegylated formulation is licensed for use as combination therapy in adult patients with metastatic pancreatic adenocarcinoma. Irin…

Pancreatic cystic lesions: position paper of the SIRM-AISP multidisciplinary group.

La Radiologia medica · 2026 · PMID 42340659

Pancreatic cystic lesions represent an increasingly common clinical finding due to the widespread use of cross sectional imaging, encompassing a heterogeneous spectrum ranging from benign entities to premalignant and malignant neoplasms. Their rising incidence poses significant challenges in diagnosis, risk stratification, and management, requiring a careful balance between avoiding unnecessary interventions and preventing malignant progression. This position paper, developed by an intersocietal multidisciplinary p…

Danish Pancreatic Cancer Group consensus guidelines on the management of pancreatic IPMN.

Acta radiologica (Stockholm, Sweden : 1987) · 2026 · PMID 42678719

BackgroundIntraductal papillary mucinous neoplasms (IPMNs) are the most common pancreatic cystic neoplasms and are increasingly detected incidentally. Although they carry malignant potential, most lesions follow an indolent course, creating a clinical challenge in balancing early cancer detection with the risks of overtreatment. Existing international guidelines differ in surveillance strategies, thresholds for intervention, and recommendations for discontinuation.PurposeTo present Danish multidisciplinary consensu…

Prognostic Value of the C-Reactive Protein-Albumin-Lymphocyte Index in Hepatobiliary and Pancreatic Cancers: A Systematic Review and Meta-Analysis.

Journal of gastrointestinal cancer · 2026 · PMID 42782412

BACKGROUND: The C-reactive protein-albumin-lymphocyte (CALLY) index integrates systemic inflammation, nutritional status, and immune competence, but evidence in hepatobiliary and pancreatic (HBP) malignancies remains uncertain. We evaluated its association with survival outcomes. METHODS: A systematic search of PubMed, Embase, Scopus, and Web of Science was performed from inception to 9 September 2026. Observational studies involving adults with hepatobiliary and pancreatic malignancies were eligible if they evalua…

European Standard Clinical Practice Guideline and EXPeRT Recommendations for the Diagnosis and Management of Gastroenteropancreatic Neuroendocrine Neoplasms in Children and Adolescents.

Pediatric blood & cancer · 2026 · PMID 41834272

Pediatric gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are extremely rare and clinically heterogeneous. Management has largely been extrapolated from adult practice. This European Standard Clinical Practice Guideline (ESCP), developed by the EXPeRT network in collaboration with adult NEN experts, provides (adult) evidence-informed and consensus-driven recommendations. Using a literature review and GRADE methodology, we address clinical evaluation, imaging pathology, genetics, surgical and systemic the…

Pancreatic Adenocarcinoma, Version 4.2026, NCCN Clinical Practice Guidelines In Oncology.

Journal of the National Comprehensive Cancer Network : JNCCN · 2026 · PMID 42869082

The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Pancreatic Adenocarcinoma provide multidisciplinary diagnostic workup, staging, and treatment recommendations for resectable, borderline resectable, unresectable, locally advanced, and metastatic disease. This article summarizes the studies and Panel discussion that serve as the rationale for comprehensive care recommendations included in the NCCN Guidelines for Pancreatic Adenocarcinoma.

Glucagon-like Peptide-1 receptor agonists are not associated with increased risk of pancreatic cancer: A systematic review and meta-analysis.

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · 2026 · PMID 41991368

BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely prescribed for glucose control and weight management. Concerns have arisen regarding a potential association with pancreatic ductal adenocarcinoma (PDAC), though evidence remains conflicting. We performed a systematic review and meta-analysis to evaluate PDAC risk in GLP-1 RA users. METHODS: We included studies with ≥24 weeks of follow-up assessing PDAC incidence in patients treated with GLP-1 RAs. Eligible studies included adults with typ…

Genetic basis of pancreatic steatosis: a systematic review of comparison between African and non-African populations.

Physiological genomics · 2026 · PMID 42721957

This systematic review compared genetic evidence of pancreatic steatosis across African and non-African populations to illuminate ancestry-specific mechanisms and precision-prevention opportunities. Following PRISMA guidelines for reporting, a search was conducted across PubMed, Scopus, Web of Science, and NHGRI-EBI GWAS Catalog for studies spanning 2011 to March 31, 2026. Eligible studies included genome-wide association studies (GWAS), polygenic risk score (PRS), and Mendelian randomization (MR) analyses that rep…

Impact of R0/R1 Margin Status on Overall Survival in Node-Positive Resected Pancreatic Ductal Adenocarcinoma: Meta-Analysis.

Annals of surgical oncology · 2026 · PMID 42418088

BACKGROUND: Microscopic residual disease (R1)and node-positive disease in resected pancreatic ductal adenocarcinoma (PDAC) are associated with worse survival. Some have suggested that obtaining an R0 resection is no longer relevant when patients have node-positive disease. A meta-analysis confirming this hypothesis is lacking. PATIENTS AND METHODS: A systematic review including studies with at least 50 patients with resected node-positive PDAC was conducted in PubMed, Embase, and Web of Science (inception to March …

Prognostic and predictive values of transcriptomic signatures in metastatic pancreatic cancer: A biomarker analysis of three French multicenter prospective randomized controlled phase 2 trials (Prodige35, Prodige37 and AFUGEM).

Cancer letters · 2026 · PMID 42521075

To evaluate the clinical applicability of previously established transcriptomic signatures (molecular subtypes, components and GemPred status) in metastatic pancreatic cancer, we conducted a retrospective pooled analysis of 178 patients from three phase 2 trials (PRODIGE35/37, AFUGEM; 2013-2016) testing first-line regimens (FOLFIRINOX, GemNab, FuNab, FOLFIRI3). RNA sequencing was performed on primary/metastatic tumors across French centers, with blinded assessment of subtypes (immune classical, pure basal-like, str…

Second-Line Systemic Therapy Following First-Line FOLFIRINOX or NALIRIFOX in Metastatic Pancreatic Ductal Adenocarcinoma: A Systematic Review and Meta-Analysis.

Journal of gastrointestinal cancer · 2026 · PMID 42804027

PURPOSE: FOLFIRINOX and NALIRIFOX are now preferred first-line treatments for metastatic pancreatic ductal adenocarcinoma (mPDAC), yet optimal second-line therapy after frontline triplet chemotherapy remains unclear. Prior evidence largely addressed second-line treatment after gemcitabine-based first-line therapy, limiting relevance today. We conducted the first contemporary systematic review and meta-analysis of second-line therapy after frontline triplet chemotherapy. METHODS: We searched MEDLINE, Embase, CINAHL,…

Splenic hilum nodal involvement in resected left-sided pancreatic cancer: meta-analysis.

BJS open · 2026 · PMID 42725583

BACKGROUND: Splenectomy is standard of care during left pancreatectomy for pancreatic ductal adenocarcinoma (PDAC) to obtain adequate lymphadenectomy. However, evidence supporting this approach is lacking. Splenic preservation would reduce short-term morbidity and is essential for emerging oncological adjunctive therapies, including immunotherapy and personalized cancer vaccines. This study reviewed the incidence of splenic hilum nodal involvement (SHNI) in left-sided PDAC. METHODS: A systematic review of the PubMe…

Neoadjuvant Chemoradiotherapy Versus Chemotherapy in Patients with Pancreatic Ductal Adenocarcinoma: A Systematic Review and Meta-analysis of Randomised Controlled Trials.

Annals of surgical oncology · 2026 · PMID 42545416

PURPOSE: This study was designed to evaluate the comparative outcomes of neoadjuvant chemoradiotherapy (NACR) and neoadjuvant chemotherapy (NAC) in patients with pancreatic ductal adenocarcinoma (PDAC). METHODS: Systematic search of electronic data sources was conducted, and all randomised controlled trials (RCTs) investigating outcomes of NACR and NAC in patients with PDAC were considered. Surgical resection rate, R0 resection, radiological response to treatment, and 1-5 years and overall survival were the evaluat…

Prognostic value of albumin-bilirubin grade in patients with pancreatic cancer: A systematic review and meta-analysis.

Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026 · PMID 41795748

BACKGROUND: With a five-year survival rate near 10%, pancreatic cancer is among the cancers with poor survival. Understanding the prognostic factors provides clinical insights for better decision-making. This meta-analysis aims to assess the prognostic value of the albumin-bilirubin (ALBI) grade in patients with pancreatic cancer. METHOD: A comprehensive search using "pancreatic cancer" and "ALBI grade" as keywords was conducted on the PubMed, Web of Science, Embase and Scopus until August 14, 2025. Studies investi…

Oral and Pancreatobiliary Microbiota in Cancer: A Systematic Review of Compositional Alterations and Their Clinical Implications.

Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology · 2026 · PMID 42477955

BACKGROUND: Associations between microbial dysbiosis and malignancies of the pancreatobiliary system have been described in recent studies. As a result of the limited number of studies that have been done specifically on the malignancies of the biliary tract, information regarding oral, biliary and tumour-related microbial alterations was combined to provide an overview of the microbial changes that may occur. METHODS: Studies that involved observations on the composition or presence of dysbiosis of the microbiota …

Survival After Irreversible Electroporation in Unresectable Locally Advanced Pancreatic Cancer: A Meta-Analysis.

The Journal of surgical research · 2026 · PMID 42743900

INTRODUCTION: To evaluate the overall survival (OS) time and predictors of survival in patients with unresectable locally advanced pancreatic ductal adenocarcinoma (PDAC) who were treated with irreversible electroporation (IRE). METHODS: According to PRISMA guidelines, a systematic review and random-effects meta-analysis (single-arm and comparison) with meta-regression was conducted. All studies reporting OS time after IRE in patients with unresectable locally advanced PDAC were included. RESULTS: Thirty-one studie…

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…

Sampling performance of EUS-Guided fine-needle biopsy in pancreatic neuroendocrine tumors: A systematic review and meta-analysis.

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · 2026 · PMID 42509099

BACKGROUND/OBJECTIVES: Pancreatic neuroendocrine tumors (PNETs) account for a growing proportion of pancreatic lesions. Adequate tissue acquisition is essential for accurate diagnosis, tumor grading, and treatment planning. Fine-needle biopsy (FNB) has emerged as a promising alternative to fine-needle aspiration (FNA) for obtaining diagnostic samples. METHODS: We conducted a systematic review and meta-analysis of clinical trials and cohort studies evaluating the sampling performance of FNB in patients with suspecte…

Periarterial Divestment in Locally Advanced Pancreatic Cancer: Systematic Review and Single-Arm Meta-Analysis.

Journal of laparoendoscopic & advanced surgical techniques. Part A · 2026 · PMID 42253112

BACKGROUND: Periarterial divestment has emerged as an artery-preserving alternative to formal arterial resection for borderline resectable and locally advanced pancreatic cancer. However, the available evidence remains limited. This study aimed to evaluate the perioperative and oncologic outcomes of periarterial divestment in pancreatic cancer. METHODS: A systematic review was conducted using PubMed, Scopus, Web of Science, and the Cochrane Central Register to identify studies' data published up to March 2026. Cont…

Prognostic and Clinicopathological Significance of CD74 Expression in Pancreatic Ductal Adenocarcinoma: A Systematic Review and Meta-Analysis.

International journal of molecular sciences · 2026 · PMID 42883736

Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal solid malignancies, and reliable prognostic biomarkers are urgently needed to guide risk stratification and treatment. CD74 has been implicated in tumor progression, invasion, and pro-inflammatory signaling in various cancers. This systematic review and meta-analysis aimed to evaluate the association between CD74 expression and key clinicopathological features and survival outcomes in patients with PDAC. A systematic literature search was conduc…

Feasibility, efficacy and safety of pressurized intraperitoneal aerosol chemotherapy (PIPAC) for hepatobiliary and pancreatic cancers with peritoneal metastases: 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 42430883

BACKGROUND: Hepato-pancreato-biliary (HPB) cancers frequently develop peritoneal metastases, signalling a poor prognosis and severely limiting the efficacy of systemic treatments. This review evaluates the feasibility, efficacy, and safety of Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) for these malignancies. METHODS: We conducted a systematic review in accordance with the PRISMA guidelines. A comprehensive, structured search strategy was applied to PubMed, Scopus, and Web of Science to identify eligib…

EUS-Guided Choledochoduodenostomy Versus Hepaticogastrostomy in Case of Concomitant Gastric Outlet Obstruction Treated by EUS-Guided Gastroenterostomy: A Systematic Review and Meta-Analysis.

United European gastroenterology journal · 2026 · PMID 42713827

BACKGROUND: Biliary (BO) and gastric outlet obstruction (GOO) frequently complicate pancreatic cancer, often delaying treatment. While EUS-guided gastroenterostomy (EUS-GE) is preferred over duodenal stenting for GOO, the optimal approach for biliary drainage (BD) between EUS-guided choledochoduodenostomy (EUS-CDS) and hepaticogastrostomy (EUS-HGS) remains undefined. This systematic review and meta-analysis aimed to identify the preferred BD strategy in patients undergoing EUS-GE for concurrent GOO and BO. METHODS:…

Effects of Glucagon-Like Peptide-1 Receptor Agonists as Weight Loss Drugs on Pancreatitis and Pancreatic Cancer: A Meta-Analysis.

Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme · 2026 · PMID 42600634

This meta-analysis aimed to clarify the association between glucagon-like peptide-1 receptor agonists, used for weight management in obesity, and the risks of pancreatitis and pancreatic cancer. We systematically searched PubMed, Web of Science, Embase, the Cochrane Library, and Scopus through June 15, 2026, for clinical studies conducted in obese populations. Peto odds ratios with 95% confidence intervals were calculated. Heterogeneity was assessed using I² statistic, and random-effects models were applied when I²…

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 as 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 …

Prognostic Value of the C-Reactive Protein-Albumin-Lymphocyte Index in Hepatobiliary and Pancreatic Cancers: A Systematic Review and Meta-Analysis.

Journal of gastrointestinal cancer · 2026 · PMID 42782412

BACKGROUND: The C-reactive protein-albumin-lymphocyte (CALLY) index integrates systemic inflammation, nutritional status, and immune competence, but evidence in hepatobiliary and pancreatic (HBP) malignancies remains uncertain. We evaluated its association with survival outcomes. METHODS: A systematic search of PubMed, Embase, Scopus, and Web of Science was performed from inception to 9 September 2026. Observational studies involving adults with hepatobiliary and pancreatic malignancies were eligible if they evalua…

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 …

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…

Cruciferous vegetables intake reduces pancreatic cancer risk: an updated systematic review with meta-analysis.

European journal of nutrition · 2024 · PMID 39078523

PURPOSE: The escalating disease burden associated with pancreatic cancer has led to its inclusion as a target of public health efforts. The relationship between the consumption of cruciferous vegetables and the incidence of pancreatic cancer has generated conflicting findings in various epidemiological studies. METHODS: Eligible studies were cohort or case-control studies reporting on the association between consumption of cruciferous vegetables and pancreatic cancer. PubMed, Cochrane, and Embase were systematicall…

Inflammatory markers in predicting survival in pancreatic cancer: A Systematic review and Meta-Analysis.

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · 2025 · PMID 40050182

INTRODUCTION: Determining an accurate prognosis for pancreatic cancer (PC) can pose significant challenges. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) has been used as prognostic factors to predict outcomes in patients with gastrointestinal cancer. This study aims to reveal the prognostic value of NLR and PLR on survival outcomes and risk of metastasis in PC. METHODS: NLR and PLR was investigated for its potential to predict survival outcomes in pancreatic ductal adenocarcinoma (PDA…

Disparities in race, ethnicity, sex, and age inclusion in pancreatic cancer screening studies: a systematic review and meta-analysis.

Gastrointestinal endoscopy · 2024 · PMID 38432492

BACKGROUND AND AIMS: Substantial differences exist in pancreatic cancer outcomes across ethnoracial stratifications. We sought to assess racial, ethnic, sex, and age reporting and inclusion of participants in pancreatic cancer screening studies. METHODS: A systematic search of Cochrane Library, Ovid Embase, Google Scholar, Ovid MEDLINE, PubMed, Scopus, and Web of Science Core Collection from inception to 2022 was conducted. Original studies on pancreatic cancer screening were identified and assessed for reporting a…

Systemic immune-inflammation index as a prognostic marker in pancreatic ductal adenocarcinoma: a metaanalysis.

Cancer treatment and research communications · 2026 · PMID 42485687

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal malignancy with limited durable treatment options despite evolving multimodal and systemic strategies. Systemic inflammation has emerged as a clinically relevant determinant of outcomes in several cancers. The systemic immune-inflammation index (SII; platelet count x neutrophil count / lymphocyte count) integrates key circulating immune cell populations and may serve as an accessible prognostic biomarker in PDAC. METHODS: A systematic search of …

Potato Consumption and Risk of Site-Specific Cancers in Adults: A Systematic Review and Dose-Response Meta-Analysis of Observational Studies.

Advances in nutrition (Bethesda, Md.) · 2021 · PMID 33861304

The etiology of cancer type may vary significantly due to anatomy, embryology, and physiology of the cancer site. Although the association between potato consumption and colorectal cancer (CRC) was summarized in a 2018 meta-analysis of 5 cohort studies, to the best of our knowledge, no meta-analysis has evaluated potato consumption in relation to multiple cancer sites in adults. Medline/PubMed, ISI Web of Knowledge, Scopus, and the Cochrane Database of Systematic Reviews were searched for relevant publications thro…

Association of Menopausal Hormone Therapy with Risk of Pancreatic Cancer: A Systematic Review and Meta-analysis of Cohort Studies.

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2023 · PMID 36306390

BACKGROUND: Although menopausal hormone therapy (MHT) is commonly prescribed, little is known about the association between MHT use and risk of pancreatic cancer. METHODS: We searched PubMed, Embase, and Cochrane Library, from inception until April 20, 2022. The risk of bias was assessed with the Newcastle-Ottawa Quality Assessment Scale. Pooled relative risks (RR) for pancreatic cancer risk were calculated using random-effects models. We computed prediction intervals (PI) and performed subgroup meta-analyses. Meta…

Association between D-dimer levels and clinicopathological characteristics of pancreatic cancer and its role in prognosis: A systematic review and meta-analysis.

Asian journal of surgery · 2024 · PMID 38453610

According to previous studies, D-dimer levels are associated with the prognosis of patients with pancreatic cancer (PC). However, the results of current studies are limited and controversial. Therefore, we performed this meta-analysis to assess the relationship between D-dimer levels and prognostic and pathological characteristics of PC patients. We first searched the databases of PubMed, Embase, The Cochrane Library, Web Of Science, CBM, VIP, CNKI and Wanfang to identify available studies. The relationship between…

Splenic hilum nodal involvement in resected left-sided pancreatic cancer: meta-analysis.

BJS open · 2026 · PMID 42725583

BACKGROUND: Splenectomy is standard of care during left pancreatectomy for pancreatic ductal adenocarcinoma (PDAC) to obtain adequate lymphadenectomy. However, evidence supporting this approach is lacking. Splenic preservation would reduce short-term morbidity and is essential for emerging oncological adjunctive therapies, including immunotherapy and personalized cancer vaccines. This study reviewed the incidence of splenic hilum nodal involvement (SHNI) in left-sided PDAC. METHODS: A systematic review of the PubMe…

Impact of prior conventional irinotecan use on nanoliposomal irinotecan efficacy in advanced pancreatic cancer: a meta-analysis.

ESMO open · 2026 · PMID 42462278

BACKGROUND: Nanoliposomal irinotecan (nal-IRI) has become an established therapy for advanced pancreatic ductal adenocarcinoma (PDAC), both in the post-gemcitabine setting and, more recently, in the first-line NALIRIFOX regimen. Concerns remain regarding cross-resistance in patients previously exposed to conventional irinotecan. We performed a systematic review and meta-analysis to evaluate the impact of prior irinotecan exposure on outcomes with nal-IRI. MATERIALS AND METHODS: We conducted a systematic literature …

Electroporation for the Treatment of Pancreatic Ductal Adenocarcinoma: A Systematic Review of Preclinical and Clinical Studies.

Clinical and translational gastroenterology · 2025 · PMID 40879173

INTRODUCTION: Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy with poor prognosis and limited treatment options. Electroporation-based therapies, such as electrochemotherapy (ECT) and irreversible electroporation (IRE), could be promising alternatives. ECT combines reversible electroporation with chemotherapy, enhancing intracellular drug uptake, while IRE leads to nonthermal tumor ablation. Both have been suggested as immunotherapy potentiators (electroimmunotherapy) in some tumor locatio…

Value addition by subspecialty trained radiologists in multidisciplinary tumor boards for pancreatic adenocarcinoma: a systematic review and meta-analysis.

La Radiologia medica · 2026 · PMID 41166033

OBJECTIVE: To perform a systematic review assessing the role of subspecialty radiologist in a multidisciplinary team (MDT) focused on pancreatic adenocarcinoma (PDAC) and the impact on patient outcomes. METHODS AND MATERIALS: Ovid MEDLINE, Ovid Embase, Cochrane Database of Systematic Reviews (Ovid), Cochrane Central Register of Controlled Trials (Ovid), and Web of Science searched until August 31, 2023, for studies including radiology review in PDAC MDT. Data extraction, risk of bias, and applicability assessment w…

The Oncological Stress Test of Neoadjuvant Therapy: A Systematic Review in Outcomes of Neoadjuvant Therapy Compared to Upfront Resection Approach for Borderline Resectable Pancreatic Adenocarcinoma.

The American surgeon · 2024 · PMID 38635295

Pancreatic adenocarcinoma, increasingly diagnosed in the United States, has a disheartening initial resection rate of 15%. Neoadjuvant therapy, particularly FOLFIRINOX and gemcitabine-based regimens, is gaining favor for its potential to improve resectability rates and achieving microscopically negative margins (R0) in borderline resectable cases, marked by intricate arterial or venous involvement. Despite surgery being the sole curative approach, actual benefit of neoadjuvant therapy remains debatable. This study …

Prognostic value of albumin-bilirubin grade in patients with pancreatic cancer: A systematic review and meta-analysis.

Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026 · PMID 41795748

BACKGROUND: With a five-year survival rate near 10%, pancreatic cancer is among the cancers with poor survival. Understanding the prognostic factors provides clinical insights for better decision-making. This meta-analysis aims to assess the prognostic value of the albumin-bilirubin (ALBI) grade in patients with pancreatic cancer. METHOD: A comprehensive search using "pancreatic cancer" and "ALBI grade" as keywords was conducted on the PubMed, Web of Science, Embase and Scopus until August 14, 2025. Studies investi…

The prognostic value of CLDN18.2 expression in pancreatic ductal adenocarcinoma: a systematic review and individual patient data meta-analysis.

Virchows Archiv : an international journal of pathology · 2026 · PMID 41091169

Pancreatic ductal adenocarcinoma (PDAC) is the most common malignant tumor of the exocrine pancreas. Due to the limited treatment options currently available and the challenges in timely and accurate screening, most patients experience rapid disease progression following initial diagnosis. CLDN18.2, an isoform of claudin-18, is normally expressed in gastric tissues but can be ectopically expressed in PDAC. This biomarker remains underexplored in the context of PDAC, and its association with patient prognosis is not…

Comparison of efficacy and safety between neoadjuvant therapy and surgical treatment for resectable pancreatic cancer: A systematic review and meta-analysis of randomized controlled trials.

Medicine · 2025 · PMID 40988297

BACKGROUND: Neoadjuvant therapy (NAT)'s potential impact on the long-term overall survival of patients with resectable pancreatic cancer (RPC) remains uncertain. This study aims to evaluate the efficacy and safety of NAT compared with upfront surgery (US) in patients with RPC. METHODS: From January 1, 2009 to October 1, 2024, we comprehensively searched PubMed, EMBASE, Web of Science, and Cochrane Library databases to identify randomized controlled trials comparing NAT with US for RPC. The primary outcomes were the…

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…

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…

Radiofrequency ablation (RFA) in unresectable pancreatic adenocarcinoma: meta-analysis & systematic review.

Surgical endoscopy · 2025 · PMID 39658672

BACKGROUND: Pancreatic adenocarcinoma remains a challenging malignancy with a poor prognosis. Radiofrequency ablation (RFA) has emerged as a potential treatment for unresectable pancreatic adenocarcinoma (UPAC) aimed at improving survival and quality of life. This meta-analysis and systematic review evaluates the outcomes of RFA in UPAC. METHODS: A comprehensive search was conducted in MEDLINE, Embase, Scopus, and Cochrane Central databases from inception to October 2023. Studies included patients over 18 years wit…

Prognostic relevance of the revised R status definition in pancreatic cancer: meta-analysis.

BJS open · 2022 · PMID 35301513

BACKGROUND: The prognostic impact of margin status is reported with conflicting results after pancreatic cancer resection. While some studies validated an uninvolved resection margin (R0) 1 mm or more of tumour clearance, others have failed to show benefit. This systematic review and meta-analysis aimed to investigate the effects of margin definitions on median overall survival (OS). METHODS: MEDLINE, Web of Science, and the Cochrane Central Register of Controlled Trials were searched for studies reporting associat…

Discordant reporting of VTE in pancreatic cancer: A systematic review and meta-analysis of thromboprophylaxis versus chemotherapeutic trials.

Journal of thrombosis and haemostasis : JTH · 2021 · PMID 33174368

BACKGROUND: Despite the frequency of venous thromboembolism (VTE) in pancreatic cancer, it is inconsistently reported as an adverse event in clinical trials. We hypothesized that reported rates of VTE in pancreatic cancer clinical trials are influenced by the objectives of the trial, with higher rates reported in thromboprophylaxis compared with chemotherapeutic trials. We performed a systematic review and meta-analysis of randomized, controlled trials (RCT) in pancreatic cancer to quantify differences in reported …

Meta-analysis of survival after pulmonary resection for isolated metachronous pancreatic cancer metastasis: a promising, albeit infrequent, approach.

HPB : the official journal of the International Hepato Pancreato Biliary Association · 2024 · PMID 38866629

BACKGROUND: To evaluate survival outcomes of pulmonary resection for isolated metachronous pancreatic cancer metastasis. METHODS: A systematic search of electronic data sources and reference lists were conducted. Proportion meta-analysis model was constructed to quantify 1- to 5-year survival after pulmonary resection for isolated metachronous pancreatic cancer metastasis. Random-effects modelling was applied to calculate pooled outcome data. RESULTS: Twenty-four retrospective studies were included reporting a tota…

Comparison of Practice Guidelines, BRCAPRO, and Genetic Counselor Estimates to Identify Germline BRCA1 and BRCA2 Mutations in Pancreatic Cancer.

Journal of genetic counseling · 2018 · PMID 29441441

Germline BRCA1 and BRCA2 (BRCA) mutation carriers with pancreatic ductal adenocarcinoma (PDAC) may benefit from precision therapies and their relatives should undergo tailored cancer prevention. In this study, we compared strategies to identify BRCA carriers with PDAC. Incident cases of PDAC were prospectively recruited for BRCA sequencing. Probands were evaluated using the National Comprehensive Cancer Network (NCCN) and the Ontario Ministry of Health and Long-Term Care (MOHLTC) guidelines. The probability of each…

Beyond predictive performance: A systematic review and critical methodological appraisal of AI/ML and conventional modelling strategies in breast, colorectal, and pancreatic Cancer.

Artificial intelligence in medicine · 2026 · PMID 42641254

BACKGROUND: Predictive modelling for cancer risk, treatment-related complications, and survival is central to precision oncology. Conventional logistic regression (LR) and Cox proportional hazards (CoxPH) regression remain widely used but are limited when modelling nonlinear interactions, high-dimensional imaging features, and multimodal clinical-metabolic predictors. Artificial intelligence (AI) and machine learning (ML) methods offer expanded capability through automated feature extraction, ensemble learning, and…

UGT1A1 genotype testing for irinotecan: A guideline developed by the UK Centre of Excellence in Regulatory Science and Innovation in Pharmacogenomics (CERSI-PGx).

British journal of clinical pharmacology · 2026 · PMID 42389808

Irinotecan, a topoisomerase I inhibitor, is available as both non-pegylated and pegylated formulations. The non-pegylated formulation is licensed for use in advanced colorectal cancer either in combination with other agents or as monotherapy. However, it is also used off-label across a range of gastrointestinal malignancies and in rare malignancies such as glioblastoma and sarcomas. The pegylated formulation is licensed for use as combination therapy in adult patients with metastatic pancreatic adenocarcinoma. Irin…

Pancreatic cystic lesions: position paper of the SIRM-AISP multidisciplinary group.

La Radiologia medica · 2026 · PMID 42340659

Pancreatic cystic lesions represent an increasingly common clinical finding due to the widespread use of cross sectional imaging, encompassing a heterogeneous spectrum ranging from benign entities to premalignant and malignant neoplasms. Their rising incidence poses significant challenges in diagnosis, risk stratification, and management, requiring a careful balance between avoiding unnecessary interventions and preventing malignant progression. This position paper, developed by an intersocietal multidisciplinary p…

Danish Pancreatic Cancer Group consensus guidelines on the management of pancreatic IPMN.

Acta radiologica (Stockholm, Sweden : 1987) · 2026 · PMID 42678719

BackgroundIntraductal papillary mucinous neoplasms (IPMNs) are the most common pancreatic cystic neoplasms and are increasingly detected incidentally. Although they carry malignant potential, most lesions follow an indolent course, creating a clinical challenge in balancing early cancer detection with the risks of overtreatment. Existing international guidelines differ in surveillance strategies, thresholds for intervention, and recommendations for discontinuation.PurposeTo present Danish multidisciplinary consensu…

The association between circulating 25-hydroxyvitamin D and pancreatic cancer: a systematic review and meta-analysis of observational studies.

European journal of nutrition · 2024 · PMID 38170272

PURPOSE: The relationship between circulating 25-hydroxyvitamin D [25(OH)D] and pancreatic cancer has been well studied but remains unclear. The purpose of this study was to elucidate the association between circulating 25(OH)D and pancreatic cancer by using a meta-analytic approach. METHODS: PubMed, Embase, and Wed of Science databases were searched through October 15, 2022. A random or fixed-effects model was used to estimate the pooled odds ratio (OR), risk ratio (RR), hazard ratio (HR) and their 95% confidence …

Prognostic utility of the Charlson comorbidity index in pancreatic cancer: a systematic review and meta‑analysis.

World journal of surgical oncology · 2026 · PMID 42625189

OBJECTIVE: The prognosis of pancreatic cancer is extremely poor, and patients frequently present with multiple comorbidities. The Charlson Comorbidity Index (CCI) and its age-adjusted version (CACI) are widely used to quantify the burden of comorbidity. This systematic review and meta-analysis aimed to evaluate the association between CCI/CACI and survival outcomes in patients with pancreatic cancer. METHODS: We systematically searched the Cochrane Library, Embase, PubMed, and Web of Science for relevant literature…

Glucagon-like Peptide-1 receptor agonists are not associated with increased risk of pancreatic cancer: A systematic review and meta-analysis.

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · 2026 · PMID 41991368

BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely prescribed for glucose control and weight management. Concerns have arisen regarding a potential association with pancreatic ductal adenocarcinoma (PDAC), though evidence remains conflicting. We performed a systematic review and meta-analysis to evaluate PDAC risk in GLP-1 RA users. METHODS: We included studies with ≥24 weeks of follow-up assessing PDAC incidence in patients treated with GLP-1 RAs. Eligible studies included adults with typ…

Cruciferous vegetables intake reduces pancreatic cancer risk: an updated systematic review with meta-analysis.

European journal of nutrition · 2024 · PMID 39078523

PURPOSE: The escalating disease burden associated with pancreatic cancer has led to its inclusion as a target of public health efforts. The relationship between the consumption of cruciferous vegetables and the incidence of pancreatic cancer has generated conflicting findings in various epidemiological studies. METHODS: Eligible studies were cohort or case-control studies reporting on the association between consumption of cruciferous vegetables and pancreatic cancer. PubMed, Cochrane, and Embase were systematicall…

Robotic distal pancreatectomy for pancreatic ductal adenocarcinoma: a systematic review and meta-analysis of outcomes in Western vs. Eastern Centers.

Journal of robotic surgery · 2025 · PMID 41238961

Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies worldwide, with a 5-year survival rate below 10%. Surgical resection represents the only potentially curative intervention, but the technical complexity demands advanced surgical approaches. Robotic distal pancreatectomy (RDP) has emerged as a minimally invasive option, offering enhanced precision and potentially improved recovery. However, outcomes may vary significantly across regions due to differences in surgical expertise, pati…

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…

Comparing Operative Outcomes and Resection Quality in Robotic vs Open Pancreaticoduodenectomy: A Meta-analysis of 54,000 Patients.

Journal of gastrointestinal cancer · 2025 · PMID 39875624

BACKGROUND: High morbidity and mortality make pancreaticoduodenectomy (PD) one of the most complicated surgical procedures. This meta-analysis aimed to compare the outcomes of robotic pancreaticoduodenectomy (RPD) versus open pancreaticoduodenectomy (OPD). METHOD: A comprehensive literature search of PubMed, Cochrane Central, and Google Scholar was conducted from inception to November 2024. Studies comparing RPD and OPD in adults aged ≥ 18 years were included. Data for the outcomes of interest were extracted. RESUL…

Outcomes following pancreaticoduodenectomy for octogenarians: a systematic review and meta-analysis.

HPB : the official journal of the International Hepato Pancreato Biliary Association · 2024 · PMID 39266363

BACKGROUND: An increasing number of elderly patients are being diagnosed with pancreatic cancer, with increasing need to consider pancreatic surgery. This study aims to provide an updated systematic review and meta-analysis to evaluate the outcomes following pancreaticoduodenectomy in octogenarians. METHODS: A systematic review and meta-analysis was performed via a search of Medline, PubMed and Cochrane databases. Studies comparing outcomes of patients >80 years to younger patients undergoing PD were included. RESU…

Perioperative and oncologic outcomes of robot-assisted versus open surgery for pancreatic ductal adenocarcinoma: a systematic review and meta-analysis.

Journal of robotic surgery · 2024 · PMID 39039276

This systematic review and meta-analysis aimed to compare perioperative and oncologic outcomes in patients with pancreatic ductal adenocarcinoma (PDAC) treated with robotic-assisted surgery versus open laparotomy. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials (RCTs) and cohort studies up to June 15, 2024, were identified using PubMed, EMBASE, and Google Scholar. Additionally, reference lists of included studies, relevant r…

Impact of R0/R1 Margin Status on Overall Survival in Node-Positive Resected Pancreatic Ductal Adenocarcinoma: Meta-Analysis.

Annals of surgical oncology · 2026 · PMID 42418088

BACKGROUND: Microscopic residual disease (R1)and node-positive disease in resected pancreatic ductal adenocarcinoma (PDAC) are associated with worse survival. Some have suggested that obtaining an R0 resection is no longer relevant when patients have node-positive disease. A meta-analysis confirming this hypothesis is lacking. PATIENTS AND METHODS: A systematic review including studies with at least 50 patients with resected node-positive PDAC was conducted in PubMed, Embase, and Web of Science (inception to March …

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…

The Current Landscape of Clinical Trials for Immunotherapy in Pancreatic Cancer: A State-of-the-Art Review.

Journal of gastrointestinal cancer · 2024 · PMID 38976079

BACKGROUND: Pancreatic cancer remains a lethal malignancy with a 5-year survival rate below 6% and about 500,000 deaths annually worldwide. Pancreatic adenocarcinoma, the most prevalent form, is commonly associated with diabetes, chronic pancreatitis, obesity, and smoking, mainly affecting individuals aged 60 to 80 years. This systematic review aims to evaluate the efficacy of immunotherapeutic approaches in the treatment of pancreatic cancer. METHODS: A systematic search was conducted to identify clinical trials (…

Misdiagnosis of Suspected Cancer in Pancreatoduodenectomy: A Systematic Review and Prevalence Mata-Analysis.

Journal of gastrointestinal cancer · 2025 · PMID 41239143

BACKGROUND: Differentiating between pancreatic cancer (PC) and benign pancreatic lesions is challenging, leading to misdiagnosis and unnecessary pancreatoduodenectomy (PD). This systematic review and meta-analysis aimed to determine the prevalence of PC misdiagnosis in PD. METHODS: A systematic review was conducted following PRISMA guidelines and was prospectively registered on PROSPERO (CRD42024510669). We included 21 studies comprising 13,660 patients who underwent PD for suspected malignancy. A random-effects me…

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…

Comparing the operative, oncological, post-operative outcomes and complications of robotic and laparoscopic pancreaticoduodenectomy for the treatment of pancreatic and periampullary cancers: a systematic review and meta-analysis with subgroup analysis.

Journal of robotic surgery · 2025 · PMID 40042699

The majority of previously published meta-analyses compare robotic and laparoscopic pancreaticoduodenectomy (RPD vs. LPD) across both benign and malignant lesions. This meta-analysis aims on focusing exclusively on malignant lesions, providing a detailed and targeted evaluation of operative, oncologic, and post-operative outcomes. This systematic review and meta-analysis adhered to PRISMA 2020 guidelines and the Cochrane Handbook and followed a pre-registered protocol on PROSPERO. A comprehensive search of PubMed, …

Prognostic and predictive values of transcriptomic signatures in metastatic pancreatic cancer: A biomarker analysis of three French multicenter prospective randomized controlled phase 2 trials (Prodige35, Prodige37 and AFUGEM).

Cancer letters · 2026 · PMID 42521075

To evaluate the clinical applicability of previously established transcriptomic signatures (molecular subtypes, components and GemPred status) in metastatic pancreatic cancer, we conducted a retrospective pooled analysis of 178 patients from three phase 2 trials (PRODIGE35/37, AFUGEM; 2013-2016) testing first-line regimens (FOLFIRINOX, GemNab, FuNab, FOLFIRI3). RNA sequencing was performed on primary/metastatic tumors across French centers, with blinded assessment of subtypes (immune classical, pure basal-like, str…

Systemic immune-inflammation index as a prognostic marker in pancreatic ductal adenocarcinoma: a metaanalysis.

Cancer treatment and research communications · 2026 · PMID 42485687

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal malignancy with limited durable treatment options despite evolving multimodal and systemic strategies. Systemic inflammation has emerged as a clinically relevant determinant of outcomes in several cancers. The systemic immune-inflammation index (SII; platelet count x neutrophil count / lymphocyte count) integrates key circulating immune cell populations and may serve as an accessible prognostic biomarker in PDAC. METHODS: A systematic search of …

Second-Line Systemic Therapy Following First-Line FOLFIRINOX or NALIRIFOX in Metastatic Pancreatic Ductal Adenocarcinoma: A Systematic Review and Meta-Analysis.

Journal of gastrointestinal cancer · 2026 · PMID 42804027

PURPOSE: FOLFIRINOX and NALIRIFOX are now preferred first-line treatments for metastatic pancreatic ductal adenocarcinoma (mPDAC), yet optimal second-line therapy after frontline triplet chemotherapy remains unclear. Prior evidence largely addressed second-line treatment after gemcitabine-based first-line therapy, limiting relevance today. We conducted the first contemporary systematic review and meta-analysis of second-line therapy after frontline triplet chemotherapy. METHODS: We searched MEDLINE, Embase, CINAHL,…

[Diagnostic Imaging of pancreatic carcinoma-Update of the new guideline].

Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2022 · PMID 35307787

The new German S3 guidelines on ductal pancreatic adenocarcinoma were published for the first time on the homepage of the Association of the Scientific Medical Societies in Germany (AWMF) in December 2021 as a new update and thus the second update (first update 2013) and contain a large number of innovations in terms of diagnostics and treatment. The guidelines were organized and led by the German Society for Digestive and Metabolic Diseases (DGVS). In this article we would like to present the central content and i…

Global trends in robotic duodenopancreatectomy for cancer: a systematic review and meta-analysis.

Journal of robotic surgery · 2025 · PMID 41014394

Robotic duodenopancreatectomy (RDP) has emerged as a transformative approach in pancreatic surgery, though its global adoption patterns and outcomes remain incompletely characterized. This systematic review and meta-analysis synthesizes data from 32 studies encompassing 3218 patients across North America, Europe, and Asia, representing the most comprehensive evaluation of RDP outcomes to date. Our analysis reveals a mean operative time of 356 min (95% CI 328-384; I2 = 89%), with significant regional variation-North…

Prognostic Value of the C-Reactive Protein-Albumin-Lymphocyte Index in Hepatobiliary and Pancreatic Cancers: A Systematic Review and Meta-Analysis.

Journal of gastrointestinal cancer · 2026 · PMID 42782412

BACKGROUND: The C-reactive protein-albumin-lymphocyte (CALLY) index integrates systemic inflammation, nutritional status, and immune competence, but evidence in hepatobiliary and pancreatic (HBP) malignancies remains uncertain. We evaluated its association with survival outcomes. METHODS: A systematic search of PubMed, Embase, Scopus, and Web of Science was performed from inception to 9 September 2026. Observational studies involving adults with hepatobiliary and pancreatic malignancies were eligible if they evalua…

Systemic immune-inflammation index as a prognostic marker in pancreatic ductal adenocarcinoma: a metaanalysis.

Cancer treatment and research communications · 2026 · PMID 42485687

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal malignancy with limited durable treatment options despite evolving multimodal and systemic strategies. Systemic inflammation has emerged as a clinically relevant determinant of outcomes in several cancers. The systemic immune-inflammation index (SII; platelet count x neutrophil count / lymphocyte count) integrates key circulating immune cell populations and may serve as an accessible prognostic biomarker in PDAC. METHODS: A systematic search of …

Deep learning models for pancreatic cancer detection on CT: a meta-analysis.

Frontiers in medicine · 2026 · PMID 42807151

This systematic review and meta-analysis evaluates the diagnostic accuracy of deep learning models for detecting pancreatic ductal adenocarcinoma using computed tomography scans. A systematic literature search of PubMed, Web of Science, and the Cochrane Library was conducted for studies published up to September 11, 2025. Study screening and data extraction were performed independently by two reviewers. Studies utilizing deep learning models for pancreatic ductal adenocarcinoma detection on computed tomography, wit…

Prognostic significance of NLRP-3 expression in solid cancers: a systematic review and meta-analysis.

Annals of medicine · 2026 · PMID 42625285

BACKGROUND: The inflammasome is a critical immunological sensor comprised of NLRP-3, ASC, and CASPASE-1. Mutations in NLRP-3 are prevalent in inflammatory diseases. However, the role of NLRP-3 in cancer is controversial. This study investigates whether NLRP-3 expression is associated with clinical outcomes in patients with solid cancers. METHODS: PubMed (MEDLINE), Embase, Cochrane, and Google Scholar were searched for articles reporting NLRP-3 expression and disease outcome data in cancer patients. RevMan Review Ma…

The influence of somatostatin analogues on the incidence of pancreatic fistulas and postoperative morbidity in patients undergoing pancreatic resection: A Bayesian network meta-analysis.

PloS one · 2025 · PMID 40971392

BACKGROUND: Pancreatic resection is a critical treatment for pancreatic cancer and other pancreatic diseases. Somatostatin analogs are commonly used to prevent complications following pancreatic resection, but their efficacy and safety remain debated. METHODS: Following PRISMA guidelines, a systematic search was conducted across multiple databases, including PubMed, EMBASE, Scopus, Cochrane Library, Ovid, ClinicalTrials.gov, Web of Science, CNKI, and WanFang Data. The search focused on studies comparing the use of …

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…

Vertical distribution of accessory canals in different tooth types: A systematic review and meta-analysis.

Journal of dentistry · 2026 · PMID 42492648

OBJECTIVE: To systematically analyze the vertical distribution of accessory canals and propose potential root-end resection levels in different tooth types. DATA: Proportional distribution of accessory canals (PD-AC) in 1 mm intervals, cumulative proportions within 2 mm and 3 mm (CP-AC0-2 and CP-AC0-3), mean distance from accessory foramen to root apex or main foramen (MD-AF), and prevalence of accessory canals in 2D cross-sections (PR-AC-2D). SOURCES: A systematic search of electronic databases was conducted throu…

Preclinical evidence for cytokine-based immunotherapy in pancreatic cancer treatment: A systematic review.

International journal of biological macromolecules · 2026 · PMID 42431486

Pancreatic cancer remains one of the most lethal malignancies, characterized by a highly immunosuppressive tumor microenvironment (TME) and a dense desmoplastic stroma, representing a significant challenge to immunotherapy application. This systematic review evaluates cytokine-based immunotherapy as a strategy to overcome these barriers. Following PRISMA guidelines, we searched PubMed, SCOPUS, and Web of Science for original preclinical studies published between 2020 and 2025 that evaluated the administration or in…

Pain response after palliative-intent radiotherapy for pancreatic cancer: a systematic review.

International journal of clinical oncology · 2026 · PMID 42566091

BACKGROUND: To date, no review has specifically focused on palliative-intent radiotherapy (RT) for pancreatic cancer (PC)-related pain. This study aimed to evaluate the pain response after palliative-intent RT for PC-related pain. METHODS: A comprehensive literature search was conducted using PubMed, Ichushi-Web, and the Cochrane Library for studies published between 1971 and 2024. Studies in which palliative-intent RT was administered for PC-related pain were included. Extracted Data were independently assessed by…

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 …

'Posterior (SMA-first) Approach' Versus 'Standard Approach' in Terms of Resection Margin and Long-Term Survival After Pancreaticoduodenectomy for Periampullary and Pancreatic Carcinoma: A Randomized Trial.

Journal of surgical oncology · 2026 · PMID 42693632

INTRODUCTION: SMA-first-approach in pancreaticooduodenectomy (PD) was found to be associated with better oncological outcomes as compared to the standard approach both in our pilot study and a few retrospective studies. Hence, we performed a randomized controlled trial to compare these two approaches in terms of resection margins, lymph node-retrieval, and long-term survival. METHODS: Between January 2014 to December 2018, all the consecutive patients undergoing PD for periampullary cancer at the Department of Gast…

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…

Impact of multidimensional health management on postoperative nutrition and mobility in patients undergoing pancreatic tumor surgery.

Nutricion hospitalaria · 2026 · PMID 42125901

Introduction: pancreatic tumors represent a malignant disease of the digestive system. Objective: to evaluate the effectiveness of a cross-dimensional integrated perioperative health management intervention on patients with pancreatic tumors. Methods: a cohort of 112 patients with pancreatic tumors who underwent surgery between January 2023 and April 2025 were selected and randomly assigned in equal numbers to a control group (n = 56) and an intervention group (n = 56) using the random number table method. The cont…

Sweetened Beverages and Pancreatic Cancer: Insights From Recent Epidemiological Data and Oncogenic Mechanisms.

Molecular nutrition & food research · 2026 · PMID 42806724

PURPOSE OF REVIEW: Hyperglycemia and altered carbohydrate metabolism may promote pancreatic cancer cell survival and proliferation. This narrative review critically evaluates epidemiological evidence on whether sugar-sweetened beverage (SSB) consumption is associated with pancreatic cancer risk and examines potential biological mechanisms involving glucose and fructose metabolism, oncogenic KRAS signaling, and metabolic reprogramming. RECENT FINDINGS: Earlier pooled analyses and a 2019 meta-analysis found no signif…

Efficacy and Safety of Cadonilimab in Digestive System Neoplasms: A Systematic Review and Single-Arm Meta-Analysis.

Pharmaceuticals (Basel, Switzerland) · 2026 · PMID 42797394

Objective: This study aimed to systematically evaluate the efficacy and safety of cadonilimab in the treatment of digestive system neoplasms. Methods: PubMed, Embase, Cochrane Library, Web of Science, Wiley Online Library, CNKI, Wanfang Data, CBM, and VIP databases were systematically searched to collect randomized controlled trials, non-randomized studies, and real-world studies investigating cadonilimab for the treatment of digestive system neoplasms. The initial search spanned from the inception of the databases…

Evaluation of Maintenance Capecitabine Therapy After First-Line Chemotherapy in Metastatic Pancreatic Cancer.

Asian Pacific journal of cancer prevention : APJCP · 2026 · PMID 42808386

OBJECTIVE: To assess the clinical impact of maintenance capecitabine following first-line modified FOLFIRINOX in patients with metastatic pancreatic cancer (mPC), focusing on progression-free survival (PFS), overall survival (OS), quality of life (QoL), and the toxicity profile. METHODS: This phase II prospective trial, 60 patients with histologically confirmed stage IV pancreatic adenocarcinoma (ECOG PS ≤1, normal organ function, and measurable metastatic disease) who were enrolled after completing modified FOLFIR…

Impact of center-level protocol adherence on neoadjuvant treatment outcome in pancreatic ductal adenocarcinoma.

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 42743889

INTRODUCTION: Chemotherapy dose reductions and delays reduce relative dose intensity (RDI) but their prognostic impact in pancreatic ductal adenocarcinoma (PDAC) remains unclear and may be influenced by heterogeneous adherence to protocol guidelines. Hence, we investigated the impact of RDI, protocol violations, and center-level protocol adherence on Event Free Survival (EFS). MATERIALS AND METHODS: This is a post hoc exploratory analysis of the preoperative part of the phase III CASSANDRA-PACT21 trial, including 2…

Intravenous hyaluronidase-expressing oncolytic adenovirus with chemotherapy in metastatic pancreatic cancer: a randomized phase 2b trial.

Nature medicine · 2026 · PMID 42816596

Zabilugene almadenorepvec (VCN-01) is a hyaluronidase-expressing oncolytic adenovirus with a favorable safety profile and encouraging antitumor activity in patients with pancreatic ductal adenocarcinoma. This randomized phase 2b trial evaluated the efficacy and safety of two doses of intravenous VCN-01 with gemcitabine and nab-paclitaxel (GnP) versus GnP alone as first-line therapy in metastatic pancreatic ductal adenocarcinoma. The primary endpoints were overall survival (OS) in the intent-to-treat and full analys…

Intraoperative esketamine for postoperative analgesia and depression in pancreatic cancer surgery: protocol for a multicenter randomized controlled trial.

Annals of medicine · 2026 · PMID 42657795

INTRODUCTION: Patients undergoing pancreatic cancer surgery frequently experience severe postoperative pain and a high prevalence of depression. Esketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, offers rapid-onset analgesic and antidepressant properties, yet its efficacy in this high-risk population remains unknown. We hypothesize that intraoperative esketamine infusion improves multidimensional analgesic benefit and reduces postoperative depression compared with placebo. PATIENTS AND METHODS: This pr…

Combination Immunotherapy in Pancreatic Cancer: Current Clinical Evidence and Mechanistic Rationale for Overcoming a "Cold" Tumor.

Cancers · 2026 · PMID 42794986

Pancreatic ductal adenocarcinoma (PDAC) resists checkpoint blockades outside uncommon molecularly selected populations. This narrative review relates clinical combination studies to four overlapping resistance mechanisms: deficient antigenicity, presentation and priming; restricted effector-cell access; suppressive myeloid and regulatory-cell programs; and T-cell dysfunction. The grouping is an organizing heuristic, not a validated treatment-selection algorithm. A source audit through 5 September 2026 reconciled a …

Endoscopic Ultrasound-Guided Gallbladder Drainage for Malignant Distal Biliary Obstruction: Current Evidence, Technical Considerations, and Future Directions.

Medicina (Kaunas, Lithuania) · 2026 · PMID 42796333

Malignant distal biliary obstruction (MDBO) is most commonly managed by endoscopic retrograde cholangiopancreatography (ERCP) with self-expandable metal stent placement. When ERCP fails or is not feasible, endoscopic ultrasound-guided biliary drainage (EUS-BD) has increasingly replaced percutaneous transhepatic biliary drainage in expert centers. Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) has emerged as an indirect route for biliary decompression when the cystic duct is patent. This comprehensive n…

Unveiling the association between plasma lipid species and pan-cancers: A bidirectional 2-sample Mendelian randomization study.

Medicine · 2026 · PMID 42798079

Plasma lipids play a crucial role at every stage of cancer progression, and a deficiency or excess of plasma lipids can lead to an increased risk of cancer. Previous observational studies and randomized controlled trials on the association between plasma lipids and cancer risk have been limited. We conducted a Mendelian randomization (MR) analysis to assess the impact of 179 plasma lipid species on the risk of 15 types of cancer. Through bidirectional 2-sample MR analysis and colocalization analysis, we systematica…

Triplet chemotherapy with Gemcitabine, Nab-paclitaxel, and S-1 achieves high response and conversion rates in advanced pancreatic cancer: A multicenter phase II study (GeNeS1S trial).

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 42748587

BACKGROUND: S-1 has demonstrated non-inferiority to gemcitabine (GEM) in overall survival (OS) in advanced pancreatic cancer and superiority in the adjuvant setting for resectable disease. This study evaluated the efficacy and safety of S-1 combined with GEM plus nab-paclitaxel (nPTX) in advanced pancreatic cancer. METHODS: This multicenter, single-arm, phase II study enrolled patients with previously untreated locally advanced, recurrent, or metastatic pancreatic cancer. Treatment consisted of GEM (600 mg/m²) and …

Direct Tumor-Adipocyte Contact as a Prognostic Biomarker in Resected Pancreatic Ductal Adenocarcinoma.

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 42777382

BACKGROUND: Direct tumor-adipocyte contact (TAC), also referred to as Stroma AReactive Invasion Front Areas (SARIFA), is an emerging histomorphologic biomarker, defined by histologically visible direct tumor-adipocyte interaction. Its prognostic relevance in pancreatic ductal adenocarcinoma (PDAC) has not been investigated across independent cohorts. METHODS: In this international, real-world, multicenter study, TAC/SARIFA was assessed on 941 resected PDAC cases across five cohorts (Munich n = 400, Bern n = 215, Gr…

Motixafortide, cemiplimab, gemcitabine and nab-paclitaxel in metastatic pancreatic cancer: a single-arm phase 2 study with single-cell correlatives.

Nature communications · 2026 · PMID 42811017

The C-X-C motif chemokine receptor 4 (CXCR4)/C-X-C motif chemokine ligand 12 (CXCL12) axis drives immune exclusion in pancreatic ductal adenocarcinoma (PDA). Building on our preclinical data, we conducted the first stage of an open-label, single-arm phase 2 clinical trial combining CXCR4 inhibition (motixafortide), PD-1 blockade (cemiplimab), and chemotherapy (gemcitabine/nab-paclitaxel [GN]; MCGN) in 11 treatment-naïve patients with metastatic PDA ( NCT04543071 ). The primary endpoint, objective response rate, was…

Deep learning models for pancreatic cancer detection on CT: a meta-analysis.

Frontiers in medicine · 2026 · PMID 42807151

This systematic review and meta-analysis evaluates the diagnostic accuracy of deep learning models for detecting pancreatic ductal adenocarcinoma using computed tomography scans. A systematic literature search of PubMed, Web of Science, and the Cochrane Library was conducted for studies published up to September 11, 2025. Study screening and data extraction were performed independently by two reviewers. Studies utilizing deep learning models for pancreatic ductal adenocarcinoma detection on computed tomography, wit…

Preclinical evidence for cytokine-based immunotherapy in pancreatic cancer treatment: A systematic review.

International journal of biological macromolecules · 2026 · PMID 42431486

Pancreatic cancer remains one of the most lethal malignancies, characterized by a highly immunosuppressive tumor microenvironment (TME) and a dense desmoplastic stroma, representing a significant challenge to immunotherapy application. This systematic review evaluates cytokine-based immunotherapy as a strategy to overcome these barriers. Following PRISMA guidelines, we searched PubMed, SCOPUS, and Web of Science for original preclinical studies published between 2020 and 2025 that evaluated the administration or in…

Motixafortide, cemiplimab, gemcitabine and nab-paclitaxel in metastatic pancreatic cancer: a single-arm phase 2 study with single-cell correlatives.

Nature communications · 2026 · PMID 42811017

The C-X-C motif chemokine receptor 4 (CXCR4)/C-X-C motif chemokine ligand 12 (CXCL12) axis drives immune exclusion in pancreatic ductal adenocarcinoma (PDA). Building on our preclinical data, we conducted the first stage of an open-label, single-arm phase 2 clinical trial combining CXCR4 inhibition (motixafortide), PD-1 blockade (cemiplimab), and chemotherapy (gemcitabine/nab-paclitaxel [GN]; MCGN) in 11 treatment-naïve patients with metastatic PDA ( NCT04543071 ). The primary endpoint, objective response rate, was…

L-Glutamine in combination with first-line gemcitabine and nab-paclitaxel in advanced pancreatic ductal adenocarcinoma: an open-label, single-arm, phase 1 GlutaPanc trial.

Nature cancer · 2026 · PMID 42675216

Exogenous L-glutamine has preclinical antitumor activity although formal clinical translation has not been attempted. We conducted a single-arm phase 1 trial to assess the safety and preliminary efficacy of clinical-grade, US Food and Drug Administration-approved L-glutamine therapy with gemcitabine and nab-paclitaxel (GA) in participants with treatment-naive, advanced pancreatic cancer (n = 16). The primary endpoint was to determine the recommended phase 2 dose (RP2D) by adaptive Bayesian design across standard do…

IGF2BP3-mediated regulation of the RNA isoform and modification landscape in pancreatic cancer.

Oncogene · 2026 · PMID 42567885

The incidence of pancreatic ductal adenocarcinoma (PDAC) is increasing but clinical outcomes remain poor and new treatments are required. IGF2BP3 is an oncofetal m6A-reading RNA regulatory protein whose expression is commonly observed in PDAC and which may represent an important therapeutic target. IGF2BP3 protein is expressed in >95% of primary tumours whilst RNA expression ranges from 3 to 3000-fold above normal epithelium. siRNA knockdown reveals IGF2BP3 to strongly support expression of gene programs related to…

The Stathmin 1-lineage Contributes to Acinar Regeneration but Not to Neoplasia Upon Oncogenic Kras Expression.

Cellular and molecular gastroenterology and hepatology · 2026 · PMID 41616822

BACKGROUND & AIMS: The exocrine pancreas has a limited regenerative capacity, but to what extent all acinar cells are involved in this process is unclear. Nevertheless, the heterogenous nature of acinar cells suggests that cells exhibiting higher plasticity might play a more prominent role in acinar regeneration. In that regard, stathmin 1 (Stmn1)-expressing acinar cells have been identified as potential facultative progenitor-like cells in the adult pancreas. Here, we studied Stmn1-progeny under physiological cond…

Molecular Spectroscopy for the Biochemical Composition Analysis of Patient-Derived Pancreatic Cancer Organoids.

Cancer medicine · 2024 · PMID 39632477

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) continues to pose profound challenges within the field of oncology due to its notorious resistance to existing therapies and constant high mortality rates. The recent emergence of three-dimensional patient-derived organoid (PDO) models marks a significant advancement, opening new avenues for exploring cancer biology and assessing therapeutic approaches. AIMS: The aim of this study focuses on the innovative use of Fourier-transform infrared (FT-IR) spectroscopy to …

Spatial Alignment of Organoids Tracking Subclonal Chemotherapy Resistance in Pancreatic and Ampullary Cancer.

Bioengineering (Basel, Switzerland) · 2023 · PMID 36671664

Pancreatic and ampullary cancers remain highly morbid diseases for which accurate clinical predictions are needed for precise therapeutic predictions. Patient-derived cancer organoids have been widely adopted; however, prior work has focused on well-level therapeutic sensitivity. To characterize individual oligoclonal units of therapeutic response, we introduce a low-volume screening assay, including an automated alignment algorithm. The oligoclonal growth response was compared against validated markers of response…

Are targeted therapies or immunotherapies effective in metastatic pancreatic adenocarcinoma?

ESMO open · 2022 · PMID 36399952

Metastatic pancreatic ductal adenocarcinoma (PDAC) is a major health burden due to its increasing incidence and poor prognosis. PDAC is characterized by a low tumor mutational burden, and its molecular pathogenesis is driven by Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations. Response to DNA damage through homologous repair is defective in 15% of tumors. Chemotherapy using FOLFIRINOX (folinic acid, fluorouracil, irinotecan, oxaliplatin) or gemcitabine-nab-paclitaxel significantly improves life expectanc…

The microbiome-derived metabolite TMAO drives immune activation and boosts responses to immune checkpoint blockade in pancreatic cancer.

Science immunology · 2022 · PMID 36083892

The composition of the gut microbiome can control innate and adaptive immunity and has emerged as a key regulator of tumor growth, especially in the context of immune checkpoint blockade (ICB) therapy. However, the underlying mechanisms for how the microbiome affects tumor growth remain unclear. Pancreatic ductal adenocarcinoma (PDAC) tends to be refractory to therapy, including ICB. Using a nontargeted, liquid chromatography-tandem mass spectrometry-based metabolomic screen, we identified the gut microbe-derived m…

NBN Pathogenic Germline Variants are Associated with Pan-Cancer Susceptibility and In Vitro DNA Damage Response Defects.

Clinical cancer research : an official journal of the American Association for Cancer Research · 2023 · PMID 36346689

PURPOSE: To explore the role of NBN as a pan-cancer susceptibility gene. EXPERIMENTAL DESIGN: Matched germline and somatic DNA samples from 34,046 patients were sequenced using Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets and presumed pathogenic germline variants (PGV) identified. Allele-specific and gene-centered analysis of enrichment was conducted and a validation cohort of 26,407 pan-cancer patients was analyzed. Functional studies utilized cellular models with analysis of…

Interleukin-1α (IL-1α) in pancreatic ductal adenocarcinoma: implications for immunotherapy and molecular biomarkers.

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026 · PMID 42033610

Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal malignancy with a 5-year survival rate of only 12%, driven by late diagnosis, rapid metastasis, and an immunosuppressive tumor microenvironment (TME). Current therapies, including chemotherapy and immune checkpoint blockade, show limited efficacy due to the "cold" TME. Interleukin-1α (IL-1α) plays a central role in PDAC progression. TCGA (n = 178) and ICGC (n = 267) analyses reveal that high IL1A expression independently predicts poor overall survival (HR =…

KRT13 Drives Pancreatic Cancer Malignancy Via the PI3K/AKT-PPARG Axis While Enhancing Sensitivity to Navitoclax.

Medical science monitor : international medical journal of experimental and clinical research · 2026 · PMID 42811535

BACKGROUND Pancreatic cancer remains one of the most aggressive malignancies, characterized by late diagnosis, limited treatment options, and a dismal prognosis, with a 5-year survival rate consistently below 13%. The molecular mechanisms driving its progression are incompletely understood, highlighting the need to identify novel regulators of oncogenic pathways. This study focused on keratin 13 (KRT13), a cytoskeletal protein, and investigated its role in pancreatic cancer pathogenesis, particularly its regulatory…

Propofol-Induced Metabolic, Apoptotic, and Wnt-Frizzled-Related Transcript Changes in MIA PaCa-2 Cells: In Vitro and Bioinformatic Analyses.

Current issues in molecular biology · 2026 · PMID 42793306

Pancreatic ductal adenocarcinoma (PDAC) remains a highly lethal malignancy, and there is continuing interest in whether agents used during the perioperative period influence tumour-cell biology. Propofol has been associated with antiproliferative and pro-apoptotic effects in experimental cancer models; however, its relationship with Wnt-Frizzled-related transcriptional responses in pancreatic cancer cells remains incompletely characterised. MIA PaCa-2 cells were exposed to propofol for 24 h. Cellular metabolic acti…

Bioengineered extracellular vesicles integrating anti-EphA2 recognition and oxaliplatin delivery for pancreatic cancer therapy.

Drug delivery · 2026 · PMID 42771518

Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal solid tumors due to its dense desmoplastic stroma, poor vascular perfusion, and the limited intratumoral delivery of chemotherapeutic agents such as oxaliplatin (OXA). Extracellular vesicles (EVs) offer a biocompatible platform for drug delivery, yet their intrinsic lack of tumor specificity constrains therapeutic efficacy. Ephrin type-A receptor 2 (EphA2), which is highly expressed and efficiently internalized in PDAC, represents an attractive …

Oncolytic virus encoding 4-1BBL and IL15 enhances the efficacy of tumor-infiltrating lymphocyte adoptive therapy in HCC.

Cancer gene therapy · 2025 · PMID 39567771

Previous studies have found that oncolytic virus (OVs) can improve the efficacy of TIL adoptive therapy in oral cancer, colon cancer, and pancreatic cancer. However, the curative effect in hepatocellular carcinoma (HCC) is still unclear. Therefore, this study aims to explore the therapeutic effect and mechanism of OVs encoding 4-1BBL and IL15 (OV-4-1BBL/IL15) combined with TIL adoptive therapy on HCC. In this study, the role and immunological mechanism of armed OVs combined with TILs were evaluated by flow cytometr…

Melanophilin-induced primary cilia promote pancreatic cancer metastasis.

Cell death & disease · 2025 · PMID 39820281

Pancreatic ductal adenocarcinoma (PDAC) is one of the most malignant tumors because of its high metastatic ability. The glutamine (Gln)-deficient microenvironment contributes to PDAC metastasis; however, the underlying molecular mechanisms remain unclear. Here, we demonstrated that melanophilin (MLPH) promotes PDAC metastasis by inducing the regrowth of primary cilia. Using RNA sequencing, we found that MLPH was upregulated in Gln-deficient conditions. MLPH facilitated PDAC metastasis in vitro and in vivo. Clinical…

Inhibition of KLF5 promotes ferroptosis via the ZEB1/HMOX1 axis to enhance sensitivity to oxaliplatin in cancer cells.

Cell death & disease · 2025 · PMID 39827156

As a novel form of nonapoptotic cell death, ferroptosis is developing into a promising therapeutic target of dedifferentiating and therapy-refractory cancers. However, its application in pancreatic cancer is still unknown. In the preliminary research, we found that F-box and WD repeat domain-containing 7 (FBW7) inhibited the migration and proliferation of pancreatic cancer cells through its substrate c-Myc. We further found that another key substrate of FBW7, KLF5, could inhibit ferroptosis. Inhibiting KLF5 signifi…

CDCA7 enhances STAT3 transcriptional activity to regulate aerobic glycolysis and promote pancreatic cancer progression and gemcitabine resistance.

Cell death & disease · 2025 · PMID 39905019

Cell division cycle associated 7 (CDCA7) plays a role in various malignancies, especially pancreatic cancer (PC). However, its expression pattern and functional significance in PC require further research. Therefore, this study aimed to investigate CDCA7 expression levels and biological functions in PC using in vitro and in vivo experiments. Western blotting, immunohistochemistry, and real-time polymerase chain reaction were performed to detect CDCA7 expression in PC cells and tissues. Additionally, the biological …

An oral tricyclic STING agonist suppresses tumor growth through remodeling of the immune microenvironment.

Cell chemical biology · 2025 · PMID 39904339

Stimulator of interferon genes (STING) agonists could overcome immunosuppressive microenvironment to improve cancer immunotherapy. However, it is challenging to develop oral STING agonists to achieve systemic immunity. In this study, we discovered ZSA-51 as a potent oral STING agonist with distinct benzo[4,5]thieno[2,3-c]pyrrole-1,3-dione scaffold through tricyclic scaffold screening. ZSA-51, as a prodrug, exhibited nanomolar in vitro STING activation activity and potent in vivo antitumor efficacy in both colon and…

Humanized Anti-MUC16 Antibody-Conjugated Contrast Agents for Magnetic Resonance Imaging of Pancreatic Cancer.

Cancers · 2025 · PMID 40149293

Background/Objectives: Pancreatic ductal adenocarcinoma (PDAC) is diagnosed at a late stage with distant metastasis in an overwhelming 50% of cases, and the prognosis is poor. Treating this extremely aggressive disease with standard-of-care therapies has led to modest benefits in overall survival, mainly due to a lack of targeted early treatment modalities, as early detection has not yet been possible. Mucin-16 (MUC16) is a glycoprotein overexpressed in more than 60% of patients with PDAC and is a tumor-specific bi…

DOCK10 Regulates Insulin Hypersecretion in Insulinoma and Serves as a Diagnostic and Therapeutic Target.

Cellular and molecular gastroenterology and hepatology · 2026 · PMID 41389876

BACKGROUND & AIMS: Insulinomas are rare pancreatic neuroendocrine neoplasms (pan-NENs) characterized by inappropriate insulin secretion. Despite advances in imaging techniques, the reliable identification of insulin-secreting lesions remains challenging. In addition, medical treatment options are limited and have seen little development in recent years, highlighting the unmet need for improved diagnostic tools and therapeutic strategies. This study aimed to identify the molecular mechanisms underlying insulin hyper…

The post-transcriptional regulator HuR promotes immune evasion in pancreatic ductal adenocarcinoma.

Cancer immunology research · 2026 · PMID 42696395

The tumor microenvironment (TME) of pancreatic ductal adenocarcinoma (PDAC) is characterized by restrained function of effector T cells that drives resistance to immunotherapy. While tumor-extrinsic stroma and myeloid cells have been shown to mediate PDAC immune evasion, the role of tumor-intrinsic post-transcriptional gene regulation in driving tumor-immune crosstalk has been relatively unexplored. Here, we report that the RNA-binding protein HuR (ELAVL1) is enriched in human PDAC and negatively correlates with T-…

Effect and mechanism of Emodin on mouse myeloid-derived suppressor cells.

Frontiers in pharmacology · 2026 · PMID 42807215

Emodin, a natural anthraquinone compound, exhibits anti-inflammatory, antioxidant, and broad-spectrum anti-tumor activities. Studies have shown that Emodin can inhibit the activation and functions of various immune cells, thereby being recognized as an important immunosuppressive agent. In this study, we conducted in vitro experiments to examine the effects of Emodin on the apoptosis, differentiation, and immunosuppressive functions of myeloid-derived suppressor cells (MDSCs), as well as its impacts on the migratio…

Engineering strategies to address immune and delivery barriers in pancreatic ductal adenocarcinoma: a barrier-matched translational framework.

Frontiers in immunology · 2026 · PMID 42807818

Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies, largely owing to profound therapeutic resistance driven by tumor heterogeneity, a highly immunosuppressive tumor microenvironment (TME), dense desmoplastic stroma, immune exclusion, and impaired antitumor immune surveillance. Although conventional chemotherapy provides limited clinical benefit, immune-based therapies have shown modest efficacy in unselected PDAC, highlighting the need for strategies that overcome the biological bar…

Co-Clinical Evaluation of Synthetic Vitamin D and Chemotherapy in Pancreatic Cancer by Integrated Imaging and Molecular Analyses.

Cancer research communications · 2026 · PMID 42574460

PURPOSE: A pilot clinical trial (NCT03519308) was conducted to evaluate perioperative chemotherapy [nab-paclitaxel, gemcitabine, and cisplatin (NGC)] plus nivolumab, with or without synthetic vitamin D (paricalcitol) in resectable pancreatic ductal adenocarcinoma (PDAC). Preclinical studies were designed with statistical power to match the experimental regimen and compare NGC only with NGC plus synthetic vitamin D [calcipotriol (Cal)] or losartan (Losa; an antihypertensive medication). MATERIALS AND METHODS: Molecu…

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) …

Effect of a MUC5AC Antibody (NPC-1C) Administered With Second-Line Gemcitabine and Nab-Paclitaxel on the Survival of Patients With Advanced Pancreatic Ductal Adenocarcinoma: A Randomized Clinical Trial.

JAMA network open · 2023 · PMID 36602796

IMPORTANCE: Treatment options are limited for patients with advanced pancreatic ductal adenocarcinoma (PDAC) beyond first-line 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX), with such individuals commonly being treated with gemcitabine and nab-paclitaxel. OBJECTIVE: To determine whether NPC-1C, an antibody directed against MUC5AC, might increase the efficacy of second-line gemcitabine and nab-paclitaxel in patients with advanced PDAC. DESIGN, SETTING, AND PARTICIPANTS: This multicenter, rando…

Effects of Auricular Acupressure on Fatigue, Sleep Quality, Physical Activity, and Quality of Life in Pancreatic Cancer Patients Undergoing Chemotherapy: A Randomized Controlled Trial.

Cancer nursing · 2026 · PMID 40179142

BACKGROUND: Patients with pancreatic cancer exhibit various symptoms and numerous physiological and psychological complications. Therefore, designing intervention measures to alleviate symptoms is crucial. OBJECTIVE: This study explored the effectiveness of a 4-week auricular acupressure intervention for reducing fatigue and improving quality of life, sleep quality, and physical activity in patients receiving chemotherapy for pancreatic cancer. METHODS: This randomized controlled trial was conducted at a medical ce…

Evaluation of Maintenance Capecitabine Therapy After First-Line Chemotherapy in Metastatic Pancreatic Cancer.

Asian Pacific journal of cancer prevention : APJCP · 2026 · PMID 42808386

OBJECTIVE: To assess the clinical impact of maintenance capecitabine following first-line modified FOLFIRINOX in patients with metastatic pancreatic cancer (mPC), focusing on progression-free survival (PFS), overall survival (OS), quality of life (QoL), and the toxicity profile. METHODS: This phase II prospective trial, 60 patients with histologically confirmed stage IV pancreatic adenocarcinoma (ECOG PS ≤1, normal organ function, and measurable metastatic disease) who were enrolled after completing modified FOLFIR…

Dosimetry Results from the Phase 1b/3 ACTION-1 Trial of [225Ac]Ac-DOTATATE (RYZ101) in Patients with Somatostatin Receptor-Expressing, Well-Differentiated GEP-NETs.

Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2026 · PMID 42242867

Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are biologically and clinically heterogeneous tumors, most of which overexpress somatostatin receptors (SSTRs). The presence of SSTRs enables staging and allows patient selection for treatment with radiolabeled somatostatin analogs (SSAs), such as DOTATATE. [225Ac]Ac-DOTATATE is an α-emitting radiopharmaceutical in development for the treatment of patients with SSTR2-expressing solid tumors. α particles have a shorter path length and higher linear energy trans…

Biomarker Analysis from Patients with Metastatic PDAC Treated with TGFβ Antibody NIS793 plus Abraxane + Gemcitabine versus Abraxane + Gemcitabine Alone in a Phase II, Open-Label, Randomized Study.

Clinical cancer research : an official journal of the American Association for Cancer Research · 2026 · PMID 42347868

PURPOSE: Transforming growth factor β (TGFβ) plays a dual role in cancer, acting as a tumor suppressor early in the disease but promoting progression and immune evasion when dysregulated. In pancreatic ductal adenocarcinoma (PDAC), TGFβ-driven desmoplasia fosters chemoresistance and immunosuppression, limiting therapeutic efficacy. NIS793, a fully human mAb targeting TGFβ, demonstrated antifibrotic and immunomodulatory activity in preclinical models and early-phase trials. PATIENTS AND METHODS: We conducted a rando…

Deep learning-based CT model for non-invasive prediction of tertiary lymphoid structures in pancreatic cancer: a multicenter study with prospective validation in an immunochemotherapy cohort.

Journal for immunotherapy of cancer · 2026 · PMID 42731878

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies. Tertiary lymphoid structures (TLS) have emerged as key components of the tumor immune microenvironment, associated with improved survival and enhanced immunotherapy response. However, non-invasive detection of TLS remains a significant clinical challenge. OBJECTIVE: This multicenter study aimed to develop and validate a deep learning-based CT model to noninvasively predict TLS status and evaluate its prognostic and pred…

Triplet chemotherapy with Gemcitabine, Nab-paclitaxel, and S-1 achieves high response and conversion rates in advanced pancreatic cancer: A multicenter phase II study (GeNeS1S trial).

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 42748587

BACKGROUND: S-1 has demonstrated non-inferiority to gemcitabine (GEM) in overall survival (OS) in advanced pancreatic cancer and superiority in the adjuvant setting for resectable disease. This study evaluated the efficacy and safety of S-1 combined with GEM plus nab-paclitaxel (nPTX) in advanced pancreatic cancer. METHODS: This multicenter, single-arm, phase II study enrolled patients with previously untreated locally advanced, recurrent, or metastatic pancreatic cancer. Treatment consisted of GEM (600 mg/m²) and …

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. …

KRAS-G12D inhibitor HRS-4642 plus chemotherapy in advanced KRASG12D-mutant pancreatic cancer: a phase 1b/2 trial.

Nature medicine · 2026 · PMID 42426224

KRASG12D is the predominant oncogenic driver in pancreatic ductal adenocarcinoma (PDAC). While most investigational KRAS-G12D inhibitors are oral small molecules limited by gastrointestinal toxicities and suboptimal tumor exposure, HRS-4642 is a new, high‑affinity, noncovalent KRAS-G12D inhibitor. Formulated as a liposomal nanoparticle for intravenous administration, it is designed to enhance tumor accumulation and prolong the duration of target inhibition. This phase 1b/2 study evaluated HRS-4642 in combination wi…

Efficacy and safety of a novel oral anti-vasculogenic mimicry agent, CVM-1118, in advanced well-differentiated neuroendocrine tumors: a Phase IIa trial.

British journal of cancer · 2026 · PMID 42393461

BACKGROUND: Highly vascularised neuroendocrine tumours (NETs) are attractive targets for foslinanib (CVM-1118), which disrupts vasculogenic mimicry and induces apoptosis via tumour necrosis factor receptor-associated protein 1. We evaluated the efficacy and safety of CVM-1118 in advanced NETs. METHODS: Patients with grades 1-2, well-differentiated lung, gastrointestinal, or pancreatic NETs, refractory or intolerant to one or more standard therapies and progressing within 6 months, received CVM-1118 (200-300 mg oral…

Acquired resistance to the RAS(ON) multi-selective inhibitor daraxonrasib guides rational combination therapy strategies in pancreatic cancer.

Nature medicine · 2026 · PMID 42581230

Daraxonrasib is an orally bioavailable RAS(ON) multi-selective tri-complex inhibitor of the oncogenic mutant and wild-type variants of N, H and KRAS. We previously reported encouraging efficacy in a phase 1/2 clinical trial evaluating daraxonrasib monotherapy at clinically active dose levels in patients with previously treated, RAS mutant metastatic pancreatic adenocarcinoma (PDAC), providing the basis for confirmatory evaluation in the randomized phase 3 RASolute 302 clinical trial. Here we report mechanisms of ac…

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…

Use of liposomal irinotecan with 5-FU and oxaliplatin (NALIRIFOX) in neoadjuvant pancreatic adenocarcinoma: NEO-Nal-IRI trial.

The oncologist · 2026 · PMID 42371783

BACKGROUND: While neoadjuvant FOLFIRINOX is an effective regimen for pancreatic ductal adenocarcinoma (PDAC), toxicity frequently limits its use. Nanoliposomal irinotecan (nal-IRI) offers improved pharmacokinetic properties and may mitigate some of the side effects. We conducted a multi-institutional, phase II study to evaluate the safety and clinical activity of neoadjuvant NALIRIFOX (nal-IRI, 5-fluorouracil, leucovorin, and oxaliplatin) in patients with resectable and borderline resectable (R/BR) PDAC. METHODS: P…

Motixafortide, cemiplimab, gemcitabine and nab-paclitaxel in metastatic pancreatic cancer: a single-arm phase 2 study with single-cell correlatives.

Nature communications · 2026 · PMID 42811017

The C-X-C motif chemokine receptor 4 (CXCR4)/C-X-C motif chemokine ligand 12 (CXCL12) axis drives immune exclusion in pancreatic ductal adenocarcinoma (PDA). Building on our preclinical data, we conducted the first stage of an open-label, single-arm phase 2 clinical trial combining CXCR4 inhibition (motixafortide), PD-1 blockade (cemiplimab), and chemotherapy (gemcitabine/nab-paclitaxel [GN]; MCGN) in 11 treatment-naïve patients with metastatic PDA ( NCT04543071 ). The primary endpoint, objective response rate, was…

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…

Dose-expansion study of OBI-999, a Globo H-targeting antibody-drug conjugate, in patients with advanced solid tumors.

The oncologist · 2026 · PMID 42371780

BACKGROUND: OBI-999 is an antibody-drug conjugate consisting of the Globo H-targeting antibody OBI-888 linked to the cytotoxic payload monomethyl auristatin E. In a dose-escalation study, the OBI-999 recommended phase 2 dose (RP2D) was 1.2 mg/kg every 3 weeks. This dose-expansion study evaluated the efficacy and safety of OBI-999 in patients with pancreatic cancer, colorectal cancer (CRC), or other tumor types ("basket cohort") and tumoral Globo H H-scores ≥100 (NCT04084366). PATIENTS AND METHODS: Patients were tre…

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…

Clinical and Proteomic Biomarkers of Trifluridine/Tipiracil in Fluoropyrimidine-Refractory Advanced Pancreatic Adenocarcinoma: A Single-Arm Phase II Trial.

JCO precision oncology · 2026 · PMID 42777178

PURPOSE: Patients with refractory pancreatic cancer have limited therapeutic option and dismal prognoses. This study aimed to evaluate the efficacy and safety of trifluridine/tipiracil (FTD/TPI) in patients with fluoropyrimidine-refractory pancreatic cancer and their predictive biomarkers. METHODS: In this single-arm phase II clinical trial, patients of refractory pancreatic cancer were enrolled and administered with FTD/TPI on days 1-5 and 8-12 of a 28-day cycle. The primary end point was the 16-week progression-f…

Prospective Phase II Trial of Biweekly Gemcitabine Plus Nab-Paclitaxel as First-Line Therapy in Patients Aged 75 Years and Older With Unresectable Pancreatic Cancer.

Cancer reports (Hoboken, N.J.) · 2026 · PMID 42735912

BACKGROUND: Although older adults (≥ 75 years) constitute a large proportion of patients with unresectable pancreatic cancer (PC), they remain underrepresented in clinical trials. Biweekly gemcitabine plus nab-paclitaxel (GnP) has been evaluated in retrospective studies as an alternative dosing schedule, whereas prospective evidence remains limited. AIMS: This single-center, prospective Phase II trial aimed to evaluate the efficacy and safety of biweekly GnP as a first-line therapy in older adults with unresectable…

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; …

Non-thermal focused ultrasound with FOLFIRINOX for borderline resectable or locally advanced pancreatic cancer: An explorative phase II trial.

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 42335570

INTRODUCTION: FOLFIRINOX is standard chemotherapy for borderline resectable (BRPC) or locally advanced pancreatic cancer (LAPC), but response rates remain suboptimal. Mechanical effect-dominant non-thermal focused ultrasound (FUS) may enhance drug delivery. This study prospectively evaluated the safety and efficacy of FUS plus FOLFIRINOX in patients with BRPC or LAPC. METHODOLOGY: In this exploratory phase II trial (NCT05262452), participants with BRPC or LAPC received FUS plus FOLFIRINOX chemotherapy during the fi…

The H63D Polymorphism in the HFE Gene Promotes Aggressive Disease Phenotypes in Pancreatic Ductal Adenocarcinoma.

Clinical cancer research : an official journal of the American Association for Cancer Research · 2026 · PMID 42440369

PURPOSE: Controversy exists regarding the association between HFE H63D polymorphism and pancreatic ductal adenocarcinoma (PDAC). This study initially assessed the frequency of H63D in patients with PDAC and subsequently investigated correlations between genotype and disease phenotype. EXPERIMENTAL DESIGN: H63D prevalence was determined by genotyping 795 patients with PDAC from two retrospective cohorts of unselected (n = 389) or surgically resected (n = 171) individuals and one prospective cohort of resectable case…

High-Sensitivity ctDNA Analysis Uncovers Relevant Signals Missed by NGS in Pancreatic Cancer.

Clinical cancer research : an official journal of the American Association for Cancer Research · 2026 · PMID 42377115

PURPOSE: Pancreatic ductal adenocarcinoma (PDAC) carries high mortality despite multimodal therapy, and improved biomarkers are needed to guide perioperative care. This study evaluated the prognostic significance of Kirsten rat sarcoma virus (KRAS)-mutant circulating tumor DNA (ctDNA) detected by next-generation sequencing (NGS) and digital droplet PCR (ddPCR) in localized PDAC. EXPERIMENTAL DESIGN: In this prospective cohort study (2020-2024), patients with localized PDAC undergoing neoadjuvant chemotherapy (NAC) …

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…

Prognostic and predictive values of transcriptomic signatures in metastatic pancreatic cancer: A biomarker analysis of three French multicenter prospective randomized controlled phase 2 trials (Prodige35, Prodige37 and AFUGEM).

Cancer letters · 2026 · PMID 42521075

To evaluate the clinical applicability of previously established transcriptomic signatures (molecular subtypes, components and GemPred status) in metastatic pancreatic cancer, we conducted a retrospective pooled analysis of 178 patients from three phase 2 trials (PRODIGE35/37, AFUGEM; 2013-2016) testing first-line regimens (FOLFIRINOX, GemNab, FuNab, FOLFIRI3). RNA sequencing was performed on primary/metastatic tumors across French centers, with blinded assessment of subtypes (immune classical, pure basal-like, str…

Potato Consumption and Risk of Site-Specific Cancers in Adults: A Systematic Review and Dose-Response Meta-Analysis of Observational Studies.

Advances in nutrition (Bethesda, Md.) · 2021 · PMID 33861304

The etiology of cancer type may vary significantly due to anatomy, embryology, and physiology of the cancer site. Although the association between potato consumption and colorectal cancer (CRC) was summarized in a 2018 meta-analysis of 5 cohort studies, to the best of our knowledge, no meta-analysis has evaluated potato consumption in relation to multiple cancer sites in adults. Medline/PubMed, ISI Web of Knowledge, Scopus, and the Cochrane Database of Systematic Reviews were searched for relevant publications thro…

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…

Endoscopic Ultrasound Guided Fine-Needle Aspiration for Solid Lesions in Chronic Pancreatitis: A Systematic Review and Meta-Analysis.

Digestive diseases and sciences · 2022 · PMID 34086166

BACKGROUND: Patients with chronic pancreatitis (CP) are at a higher risk of developing pancreatic adenocarcinoma compared the general population with an estimated 5% risk of developing pancreatic cancer in 20 years. Endoscopic ultrasound fine needle aspiration (EUS-FNA) of solid pancreatic lesions (SPL) has an excellent sensitivity (85-90%) and specificity (98-100%) for diagnosing pancreatic malignancy. However, data on the performance characteristics of EUS-FNA in CP are mixed. AIMS: In this systematic review and …

Mediterranean Diet and Risk of Pancreatic Cancer-Is It Worth Investigating More? An Updated Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies.

Cancer medicine · 2026 · PMID 42608885

BACKGROUND: Despite previous meta-analysis studies on the association between adherence to the Mediterranean diet and risk of pancreatic cancer, there has not been a comprehensive and updated study reviewing all studies with inclusion criteria. Despite advances in cancer treatment and control, pancreatic cancer is still one of the deadliest malignancies, and the mortality rate is consistent with its prevalence. Therefore, this updated systematic review and dose-response meta-analysis study was conducted to examine …

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…

Impact of obstructive sleep apnea on cancer risk: a systematic review and meta-analysis.

Sleep & breathing = Schlaf & Atmung · 2023 · PMID 36129602

PURPOSE: We aimed to study the effect of obstructive sleep apnea (OSA) on cancer risk. METHODS: We searched PubMed, Embase, and Cochrane databases for relevant studies. The qualities of included studies were assessed using Newcastle-Ottawa Scale (NOS). Unadjusted and adjusted analyses were performed. We also conducted subgroup analyses stratified by gender, severity of OSA, study design, and cancer type. RESULTS: After literatures search, 18 studies were included in the present study. In the unadjusted analysis, we…

A systematic review of prognosis predictive role of radiomics in pancreatic cancer: heterogeneity markers or statistical tricks?

European radiology · 2022 · PMID 35904618

OBJECTIVES: We aimed to systematically evaluate the prognostic prediction accuracy of radiomics features extracted from pre-treatment imaging in patients with pancreatic ductal adenocarcinoma (PDAC). METHODS: Radiomics literature on overall survival (OS) prediction of PDAC were all included in this systematic review. A further meta-analysis was performed on the effect size of first-order entropy. Methodological quality and risk of bias of the included studies were assessed by the radiomics quality score (RQS) and p…

Sweetened Beverages and Pancreatic Cancer: Insights From Recent Epidemiological Data and Oncogenic Mechanisms.

Molecular nutrition & food research · 2026 · PMID 42806724

PURPOSE OF REVIEW: Hyperglycemia and altered carbohydrate metabolism may promote pancreatic cancer cell survival and proliferation. This narrative review critically evaluates epidemiological evidence on whether sugar-sweetened beverage (SSB) consumption is associated with pancreatic cancer risk and examines potential biological mechanisms involving glucose and fructose metabolism, oncogenic KRAS signaling, and metabolic reprogramming. RECENT FINDINGS: Earlier pooled analyses and a 2019 meta-analysis found no signif…

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) …

Evaluation of Maintenance Capecitabine Therapy After First-Line Chemotherapy in Metastatic Pancreatic Cancer.

Asian Pacific journal of cancer prevention : APJCP · 2026 · PMID 42808386

OBJECTIVE: To assess the clinical impact of maintenance capecitabine following first-line modified FOLFIRINOX in patients with metastatic pancreatic cancer (mPC), focusing on progression-free survival (PFS), overall survival (OS), quality of life (QoL), and the toxicity profile. METHODS: This phase II prospective trial, 60 patients with histologically confirmed stage IV pancreatic adenocarcinoma (ECOG PS ≤1, normal organ function, and measurable metastatic disease) who were enrolled after completing modified FOLFIR…

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…

Intraoperative esketamine for postoperative analgesia and depression in pancreatic cancer surgery: protocol for a multicenter randomized controlled trial.

Annals of medicine · 2026 · PMID 42657795

INTRODUCTION: Patients undergoing pancreatic cancer surgery frequently experience severe postoperative pain and a high prevalence of depression. Esketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, offers rapid-onset analgesic and antidepressant properties, yet its efficacy in this high-risk population remains unknown. We hypothesize that intraoperative esketamine infusion improves multidimensional analgesic benefit and reduces postoperative depression compared with placebo. PATIENTS AND METHODS: This pr…

Deep learning-based CT model for non-invasive prediction of tertiary lymphoid structures in pancreatic cancer: a multicenter study with prospective validation in an immunochemotherapy cohort.

Journal for immunotherapy of cancer · 2026 · PMID 42731878

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies. Tertiary lymphoid structures (TLS) have emerged as key components of the tumor immune microenvironment, associated with improved survival and enhanced immunotherapy response. However, non-invasive detection of TLS remains a significant clinical challenge. OBJECTIVE: This multicenter study aimed to develop and validate a deep learning-based CT model to noninvasively predict TLS status and evaluate its prognostic and pred…

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…

The Concept of Biological Resectability in Pancreatic Ductal Adenocarcinoma - An Updated Narrative Review.

Annali italiani di chirurgia · 2026 · PMID 42610296

Resectability in pancreatic ductal adenocarcinoma (PDAC) has traditionally been defined according to tumor-vessel relationship on cross-sectional imaging. However, anatomical criteria alone fail to identify occult systemic disease and do not reliably predict early postoperative recurrence or the likelihood of meaningful oncological benefit from surgery. This structured narrative review evaluated contemporary evidence regarding biological resectability and the emerging role of biomarkers in perioperative decision-ma…

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…

Systemic Therapy of Advanced Well-differentiated Small Bowel Neuroendocrine Tumors Progressive on Somatostatin Analogues.

Current treatment options in oncology · 2022 · PMID 35939200

Neuroendocrine neoplasms (NENs) are a heterogeneous group of tumors whose management requires a nuanced and multi-disciplinary approach in order to control symptoms, halt tumor growth, and improve survival outcomes. Of late, the treatment landscape of NENs has advanced considerably as a result of several pivotal clinical trials, which have established somatostatin analogues as first-line therapy for advanced, metastatic, well-differentiated neuroendocrine tumors (NETs). However, an evolving classification system as…

Prospective Phase II Trial of Biweekly Gemcitabine Plus Nab-Paclitaxel as First-Line Therapy in Patients Aged 75 Years and Older With Unresectable Pancreatic Cancer.

Cancer reports (Hoboken, N.J.) · 2026 · PMID 42735912

BACKGROUND: Although older adults (≥ 75 years) constitute a large proportion of patients with unresectable pancreatic cancer (PC), they remain underrepresented in clinical trials. Biweekly gemcitabine plus nab-paclitaxel (GnP) has been evaluated in retrospective studies as an alternative dosing schedule, whereas prospective evidence remains limited. AIMS: This single-center, prospective Phase II trial aimed to evaluate the efficacy and safety of biweekly GnP as a first-line therapy in older adults with unresectable…

Irreversible electroporation to bring initially unresectable locally advanced pancreatic adenocarcinoma to surgery: the IRECAP phase II study.

European radiology · 2024 · PMID 38494526

OBJECTIVES: The aim of the IRECAP study was to evaluate the rate of locally advanced pancreas cancer patients (LAPC) who could undergo R0 or R1 surgery after irreversible electroporation (IRE). MATERIALS AND METHODS: IRECAP study is a phase II, single-center, open-label, prospective, non-randomized trial registered at clinicaltrials.gov (NCT03105921). Patients with LAPC were first treated by 3-month neo-adjuvant chemotherapy in order to avoid inclusion of either patients with LAPC having become resectable after che…

PancDS in Real-World Practice: A Prospective Multicenter Validation of a Clinical Decision-Support System Bridging Experience Gaps in Pancreatic Lesion Diagnosis.

Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026 · PMID 42153997

Distinguishing pancreatic ductal adenocarcinoma (PDAC) from mass-forming pancreatitis (MFP) is challenging due to imaging mimicry and reader-dependent variability. PancDS is developed as a biomimetic pancreatic decision-support system that integrates clinical predictors, a radiomics signature, and self-developed deep features (PANet). PancDS is enabled by TriFusionNet, an adaptive fusion strategy designed to emulate expert reasoning by dynamically reweighting modalities according to diagnostic relevance. In a retro…

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…

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…

Automated glucose control systems in post-pancreatectomy diabetes: systematic review of clinical efficacy and nursing care implications.

Minerva gastroenterology · 2026 · PMID 41801256

INTRODUCTION: Post-pancreatectomy diabetes (type 3c diabetes) is a frequent consequence of pancreatic cancer surgery and is characterized by extreme glycemic variability, high risk of severe hypoglycemia, and a substantial impact on quality of life and nursing workload. Technological solutions such as continuous glucose monitoring (CGM) and closed-loop insulin delivery may help address these challenges. EVIDENCE ACQUISITION: We conducted a systematic review according to the Cochrane Handbook 6.5 and PRISMA 2020 gui…

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 as 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 …

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…

Effects of Auricular Acupressure on Fatigue, Sleep Quality, Physical Activity, and Quality of Life in Pancreatic Cancer Patients Undergoing Chemotherapy: A Randomized Controlled Trial.

Cancer nursing · 2026 · PMID 40179142

BACKGROUND: Patients with pancreatic cancer exhibit various symptoms and numerous physiological and psychological complications. Therefore, designing intervention measures to alleviate symptoms is crucial. OBJECTIVE: This study explored the effectiveness of a 4-week auricular acupressure intervention for reducing fatigue and improving quality of life, sleep quality, and physical activity in patients receiving chemotherapy for pancreatic cancer. METHODS: This randomized controlled trial was conducted at a medical ce…

Evaluation of Maintenance Capecitabine Therapy After First-Line Chemotherapy in Metastatic Pancreatic Cancer.

Asian Pacific journal of cancer prevention : APJCP · 2026 · PMID 42808386

OBJECTIVE: To assess the clinical impact of maintenance capecitabine following first-line modified FOLFIRINOX in patients with metastatic pancreatic cancer (mPC), focusing on progression-free survival (PFS), overall survival (OS), quality of life (QoL), and the toxicity profile. METHODS: This phase II prospective trial, 60 patients with histologically confirmed stage IV pancreatic adenocarcinoma (ECOG PS ≤1, normal organ function, and measurable metastatic disease) who were enrolled after completing modified FOLFIR…

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…

Combination Immunotherapy in Pancreatic Cancer: Current Clinical Evidence and Mechanistic Rationale for Overcoming a "Cold" Tumor.

Cancers · 2026 · PMID 42794986

Pancreatic ductal adenocarcinoma (PDAC) resists checkpoint blockades outside uncommon molecularly selected populations. This narrative review relates clinical combination studies to four overlapping resistance mechanisms: deficient antigenicity, presentation and priming; restricted effector-cell access; suppressive myeloid and regulatory-cell programs; and T-cell dysfunction. The grouping is an organizing heuristic, not a validated treatment-selection algorithm. A source audit through 5 September 2026 reconciled a …

Dose response relationship of medical cannabis and symptom control in patients with pancreatic cancer: an analysis of the CANPAN trial.

The oncologist · 2026 · PMID 42767994

BACKGROUND: In a pilot waitlist-control randomized trial, a personalized medical cannabis intervention improved certain symptoms among patients with pancreatic cancer over 8 weeks. Longer-term and dose-response data can guide future trial design. METHODS: CANPAN enrolled 32 cannabis-naïve patients with newly diagnosed locally advanced/metastatic pancreatic adenocarcinoma (NCT06605430). Patients were randomized to early (0-8 weeks) or delayed (9-16 weeks) cannabis intervention. Primary efficacy results over the firs…

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…

Efficacy of intra-arterial [ 177 Lu]Lu-DOTATATE vs. continuation intravenous [ 177 Lu]Lu-DOTATATE peptide receptor radionuclide therapy in nonresponding locally advanced inoperable or liver-dominant metastatic gastroenteropancreatic neuroendocrine tumors.

Nuclear medicine communications · 2026 · PMID 42169550

BACKGROUND: Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) demonstrating liver-dominant inoperable metastatic diseases or locally advanced inoperable tumors may at times show reduced efficacy for intravenous peptide receptor radionuclide therapy (PRRT). AIMS AND OBJECTIVES: To determine and compare the outcome of intra-arterial [ 177 Lu]Lu-DOTATATE PRRT in GEP-NET with locally advanced inoperable primary or liver-dominant metastases who had shown no response after at least two cycles of intravenous [ 177 L…

The evolving role of radiotherapy in oligometastatic pancreatic cancer: from palliation to disease-modifying multidisciplinary integration.

Frontiers in oncology · 2026 · PMID 42769899

Oligometastatic pancreatic ductal adenocarcinoma (PDAC) may benefit from aggressive multidisciplinary therapy, yet the role of stereotactic body radiotherapy (SBRT) remains controversial and frameworks for patient selection remain incompletely defined. While SBRT has become a standard option in oligometastatic lung and prostate cancer, its application in PDAC faces unique challenges related to tumor biology, anatomic constraints, and a paucity of randomized evidence. This narrative review searched PubMed, Embase, a…

Multi-modal digital twin model outperforms conventional biomarker stratification in pancreatic cancer.

Frontiers in artificial intelligence · 2026 · PMID 42712492

Better patient selection for treatment is critical to improving both cancer care and therapeutic development in oncology. The ability to predict individual patient responses to cancer treatment ahead of time would transform cancer care with substantial impact on outcomes, quality of life and cost. We generated molecular digital twins of individual participants using a Bayesian foundation model of cancer (FarrSight®) in the COMPASS clinical trial (a non-randomized study of mFOLFIRINOX and gemcitabine + nab-paclitaxe…

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…

Use of liposomal irinotecan with 5-FU and oxaliplatin (NALIRIFOX) in neoadjuvant pancreatic adenocarcinoma: NEO-Nal-IRI trial.

The oncologist · 2026 · PMID 42371783

BACKGROUND: While neoadjuvant FOLFIRINOX is an effective regimen for pancreatic ductal adenocarcinoma (PDAC), toxicity frequently limits its use. Nanoliposomal irinotecan (nal-IRI) offers improved pharmacokinetic properties and may mitigate some of the side effects. We conducted a multi-institutional, phase II study to evaluate the safety and clinical activity of neoadjuvant NALIRIFOX (nal-IRI, 5-fluorouracil, leucovorin, and oxaliplatin) in patients with resectable and borderline resectable (R/BR) PDAC. METHODS: P…

Organ-preserving surgery for solid pseudopapillary neoplasm of the pancreas: A multicentric study.

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 42759262

BACKGROUND: Solid pseudopapillary neoplasms (SPNs) are rare, indolent pancreatic tumors characterized by an excellent prognosis, with a predilection for young females. While organ-preserving surgical approaches are gaining traction in clinical practice, the standard treatment for SPNs continues to rely on non-organ-preserving resection techniques-a strategy originally adapted from the management of pancreatic adenocarcinoma, a more aggressive tumor subtype. METHODS: This multicentric study employed a two-cohort des…

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

Quality of life and care experiences in a US multi-institutional neuroendocrine tumor cohort.

Journal of the National Cancer Institute · 2026 · PMID 41808486

BACKGROUND: Neuroendocrine tumors (NETs) are rare, heterogeneous neoplasms associated with prolonged survival and substantial symptom burden. However, patient-reported outcomes across NET subtypes remain poorly characterized, particularly in real-world settings. This study describes baseline health-related quality of life (HRQoL) and care experiences among patients with gastroenteropancreatic and lung NETs, examining differences by tumor site and time since diagnosis. METHODS: The Neuroendocrine Tumors-Patient Repo…

Longitudinal assessment of health-related quality of life in patients with borderline and locally advanced pancreatic cancer undergoing neoadjuvant FOLFIRINOX chemotherapy: results from a prospective multicenter trial.

Langenbeck's archives of surgery · 2026 · PMID 42384236

PURPOSE: Pancreatic ductal adenocarcinoma (PDAC) carries a poor prognosis and significantly affects health-related quality of life (HRQoL). In borderline resectable (BR) and locally advanced (LA) PDAC, neoadjuvant FOLFIRINOX may enable surgical resection, but its toxicity can further compromise HRQoL. Evidence on longitudinal HRQoL changes during FOLFIRINOX in this context remains limited. This study evaluated HRQoL trajectories in patients with BR and LA PDAC receiving neoadjuvant chemotherapy (NACT) within a surg…

Quantitative CT Perfusion as a prognostic biomarker for chemotherapy response in patients with pancreatic ductal adenocarcinoma.

Abdominal radiology (New York) · 2026 · PMID 41961316

BACKGROUND: Response evaluation of pancreatic ductal adenocarcinoma (PDAC) with routine contrast-enhanced CT (CECT) using RECIST is currently inadequate for identification of patients benefiting from chemotherapy treatment, as the majority of patients show stable disease. This might lead to inappropriate treatment and potentially diminishes patients' quality of life. Recent developments in CT perfusion (CTP) show its potential as a biomarker to evaluate therapy response in PDAC. PURPOSE: To investigate quantitative…

Perspectives on Palliative Care Among Patients With Pancreatic Cancer: A Pilot Study.

Clinical journal of oncology nursing · 2026 · PMID 42555779

BACKGROUND: Palliative care (PC) is specialized health care that can improve quality of life for patients with cancer. However, PC tends to be underutilized or relegated to end-of-life care, limiting patients' ability to benefit from patient-centered, goal-concordant care. Patients with pancreatic cancer, who are often diagnosed at an advanced stage and with high symptom burdens, could benefit from PC. A chart review conducted in 2022 at a southern New Jersey academic medical center and cancer center found that amo…

Enucleation vs Pancreatoduodenectomy for Benign and Low-Grade Pancreatic Head Tumors.

JAMA surgery · 2026 · PMID 42814443

IMPORTANCE: Pancreatic enucleation may offer a parenchyma-sparing alternative to pancreatoduodenectomy for benign and low-grade malignant pancreatic head tumors, but its perioperative risk-benefit profile relative to pancreatoduodenectomy remains incompletely defined. OBJECTIVE: To compare short-term outcomes and long-term quality of life after enucleation vs pancreatoduodenectomy for benign and low-grade malignant tumors of the pancreatic head and uncinate process. DESIGN, SETTING, AND PARTICIPANTS: This multicent…

Pain profiles in pancreatic cancer and chronic pancreatitis: a multicenter cross-sectional analysis.

Frontiers in pain research (Lausanne, Switzerland) · 2026 · PMID 42798443

INTRODUCTION: Abnormal pain processing has been associated with impaired patient-reported outcomes (PROMs) in chronic pancreatitis (CP), but its clinical relevance in pancreatic ductal adenocarcinoma (PDAC) remains unclear. We investigated the association between P-QST-defined hyperalgesia and pain-related, psychological, and quality-of-life outcomes in patients with painful PDAC and compared these associations with CP. METHODS: This multicenter cross-sectional analysis included patients with painful CP and PDAC at…

Real-world implementation of a decision aid for treatment decisions in metastatic pancreatic cancer: a prospective multicenter study across expert centers.

The oncologist · 2026 · PMID 42809229

BACKGROUND: Treatment decisions in metastatic pancreatic adenocarcinoma (mPAC) involve complex tradeoffs between survival benefits and treatment burden. Shared decision-making (SDM) is crucial but challenging in emotionally charged and time-pressured consultations. This study evaluated the real-world implementation of a decision aid to support SDM in treatment decisions in mPAC care. MATERIALS AND METHODS: In this prospective, multicenter study across 10 Dutch expert centers, patients with mPAC and their clinicians…

Glucagon-like Peptide-1 receptor agonists are not associated with increased risk of pancreatic cancer: A systematic review and meta-analysis.

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · 2026 · PMID 41991368

BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely prescribed for glucose control and weight management. Concerns have arisen regarding a potential association with pancreatic ductal adenocarcinoma (PDAC), though evidence remains conflicting. We performed a systematic review and meta-analysis to evaluate PDAC risk in GLP-1 RA users. METHODS: We included studies with ≥24 weeks of follow-up assessing PDAC incidence in patients treated with GLP-1 RAs. Eligible studies included adults with typ…

Prognostic and predictive values of transcriptomic signatures in metastatic pancreatic cancer: A biomarker analysis of three French multicenter prospective randomized controlled phase 2 trials (Prodige35, Prodige37 and AFUGEM).

Cancer letters · 2026 · PMID 42521075

To evaluate the clinical applicability of previously established transcriptomic signatures (molecular subtypes, components and GemPred status) in metastatic pancreatic cancer, we conducted a retrospective pooled analysis of 178 patients from three phase 2 trials (PRODIGE35/37, AFUGEM; 2013-2016) testing first-line regimens (FOLFIRINOX, GemNab, FuNab, FOLFIRI3). RNA sequencing was performed on primary/metastatic tumors across French centers, with blinded assessment of subtypes (immune classical, pure basal-like, str…

Second-Line Systemic Therapy Following First-Line FOLFIRINOX or NALIRIFOX in Metastatic Pancreatic Ductal Adenocarcinoma: A Systematic Review and Meta-Analysis.

Journal of gastrointestinal cancer · 2026 · PMID 42804027

PURPOSE: FOLFIRINOX and NALIRIFOX are now preferred first-line treatments for metastatic pancreatic ductal adenocarcinoma (mPDAC), yet optimal second-line therapy after frontline triplet chemotherapy remains unclear. Prior evidence largely addressed second-line treatment after gemcitabine-based first-line therapy, limiting relevance today. We conducted the first contemporary systematic review and meta-analysis of second-line therapy after frontline triplet chemotherapy. METHODS: We searched MEDLINE, Embase, CINAHL,…

Neoadjuvant Chemoradiotherapy Versus Chemotherapy in Patients with Pancreatic Ductal Adenocarcinoma: A Systematic Review and Meta-analysis of Randomised Controlled Trials.

Annals of surgical oncology · 2026 · PMID 42545416

PURPOSE: This study was designed to evaluate the comparative outcomes of neoadjuvant chemoradiotherapy (NACR) and neoadjuvant chemotherapy (NAC) in patients with pancreatic ductal adenocarcinoma (PDAC). METHODS: Systematic search of electronic data sources was conducted, and all randomised controlled trials (RCTs) investigating outcomes of NACR and NAC in patients with PDAC were considered. Surgical resection rate, R0 resection, radiological response to treatment, and 1-5 years and overall survival were the evaluat…

Survival After Irreversible Electroporation in Unresectable Locally Advanced Pancreatic Cancer: A Meta-Analysis.

The Journal of surgical research · 2026 · PMID 42743900

INTRODUCTION: To evaluate the overall survival (OS) time and predictors of survival in patients with unresectable locally advanced pancreatic ductal adenocarcinoma (PDAC) who were treated with irreversible electroporation (IRE). METHODS: According to PRISMA guidelines, a systematic review and random-effects meta-analysis (single-arm and comparison) with meta-regression was conducted. All studies reporting OS time after IRE in patients with unresectable locally advanced PDAC were included. RESULTS: Thirty-one studie…

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 …

Automated glucose control systems in post-pancreatectomy diabetes: systematic review of clinical efficacy and nursing care implications.

Minerva gastroenterology · 2026 · PMID 41801256

INTRODUCTION: Post-pancreatectomy diabetes (type 3c diabetes) is a frequent consequence of pancreatic cancer surgery and is characterized by extreme glycemic variability, high risk of severe hypoglycemia, and a substantial impact on quality of life and nursing workload. Technological solutions such as continuous glucose monitoring (CGM) and closed-loop insulin delivery may help address these challenges. EVIDENCE ACQUISITION: We conducted a systematic review according to the Cochrane Handbook 6.5 and PRISMA 2020 gui…

Stereotactic body radiation therapy for pancreatic cancer: evaluating its efficacy, safety, and future prospects: systematic review.

The British journal of radiology · 2026 · PMID 42635528

OBJECTIVES: This systematic narrative review evaluates the efficacy, safety, and future potential of stereotactic body radiation therapy (SBRT) in locally advanced pancreatic cancer (LAPC), particularly for patients unsuitable for surgery. METHODS: A systematic search of PubMed, Embase, and the Cochrane Library identified English and select non-English studies published between January 2010 and November 2025. Search terms included "pancreatic cancer," "SBRT," "LAPC," "adaptive radiotherapy," "proton therapy," "toxi…

Cost-effectiveness Analysis of Robotic Versus Open Pancreatoduodenectomy (DIPLOMA-2): A Multicenter International Randomized Trial.

Annals of surgery · 2026 · PMID 42606345

BACKGROUND: Although robot-assisted pancreatoduodenectomy (RPD) enhances patient recovery, it could be associated with higher costs than open pancreatoduodenectomy (OPD), potentially limiting its widespread adoption. High-level evidence comparing costs of RPD and OPD is lacking. This analysis in a randomized trial compared costs and cost-effectiveness between RPD and OPD. METHODS: Predefined cost-effectiveness analysis in the international randomized DIPLOMA-2 trial (ISRCTN27483786) comparing RPD and OPD in patient…

Adjuvant Chemotherapy ± Chemoradiotherapy for Adenocarcinoma of the Pancreatic Head: Results of the Radiotherapy Random Assignment of NRG Oncology/RTOG 0848.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2026 · PMID 42456089

PURPOSE: To assess whether adding fluoropyrimidine sensitized radiotherapy (CXRT) to adjuvant chemotherapy improves overall survival (OS) after curative intent resection of the pancreatic head. METHODS: This was a multicenter, randomized phase III, two step trial. Step 1: gemcitabine versus gemcitabine + erlotinib (previously reported). Step 2: random assignment to sixth chemotherapy cycle ± CXRT after five cycles of step 1 chemotherapy without progression. Outcomes of step 2 random assignment are reported here. As…

Is there a role for early SSTR-targeting PRRT in GEP-NET?

European journal of nuclear medicine and molecular imaging · 2026 · PMID 42234009

PURPOSE: Peptide receptor radionuclide therapy (PRRT) with radiolabelled somatostatin analogues, such as [¹⁷⁷Lu]Lu-DOTATATE, is approved as a second-line treatment for progressive, gastroenteropancreatic neuroendocrine tumors (GEP-NETs). However, emerging evidence suggests potential earlier roles for PRRT. MATERIALS AND METHODS: A systematic review was conducted in accordance with the PRISMA guidelines, including case reports, original papers, and clinical trial protocols evaluating neoadjuvant, adjuvant, or first-…

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…

Vertical distribution of accessory canals in different tooth types: A systematic review and meta-analysis.

Journal of dentistry · 2026 · PMID 42492648

OBJECTIVE: To systematically analyze the vertical distribution of accessory canals and propose potential root-end resection levels in different tooth types. DATA: Proportional distribution of accessory canals (PD-AC) in 1 mm intervals, cumulative proportions within 2 mm and 3 mm (CP-AC0-2 and CP-AC0-3), mean distance from accessory foramen to root apex or main foramen (MD-AF), and prevalence of accessory canals in 2D cross-sections (PR-AC-2D). SOURCES: A systematic search of electronic databases was conducted throu…

Pancreatodudenectomy versus total pancreatectomy in patients at high risk of pancreatic fistula: A systematic review of the literature.

Journal of visceral surgery · 2026 · PMID 42392942

INTRODUCTION: Postoperative pancreatic fistula (POPF) remains one of the most dreaded complications after pancreatoduodenectomy (PD), especially in patients with soft pancreatic parenchyma and a small main pancreatic duct. In this context, total pancreatectomy (TP) has been proposed to prevent the occurrence of POPF, although its metabolic consequences limit its widespread adoption. OBJECTIVE: To compare the postoperative outcomes of PD and TP in patients at high risk of POPF, assessing morbidity, mortality, and me…

Pain response after palliative-intent radiotherapy for pancreatic cancer: a systematic review.

International journal of clinical oncology · 2026 · PMID 42566091

BACKGROUND: To date, no review has specifically focused on palliative-intent radiotherapy (RT) for pancreatic cancer (PC)-related pain. This study aimed to evaluate the pain response after palliative-intent RT for PC-related pain. METHODS: A comprehensive literature search was conducted using PubMed, Ichushi-Web, and the Cochrane Library for studies published between 1971 and 2024. Studies in which palliative-intent RT was administered for PC-related pain were included. Extracted Data were independently assessed by…

'Posterior (SMA-first) Approach' Versus 'Standard Approach' in Terms of Resection Margin and Long-Term Survival After Pancreaticoduodenectomy for Periampullary and Pancreatic Carcinoma: A Randomized Trial.

Journal of surgical oncology · 2026 · PMID 42693632

INTRODUCTION: SMA-first-approach in pancreaticooduodenectomy (PD) was found to be associated with better oncological outcomes as compared to the standard approach both in our pilot study and a few retrospective studies. Hence, we performed a randomized controlled trial to compare these two approaches in terms of resection margins, lymph node-retrieval, and long-term survival. METHODS: Between January 2014 to December 2018, all the consecutive patients undergoing PD for periampullary cancer at the Department of Gast…

Impact of center-level protocol adherence on neoadjuvant treatment outcome in pancreatic ductal adenocarcinoma.

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 42743889

INTRODUCTION: Chemotherapy dose reductions and delays reduce relative dose intensity (RDI) but their prognostic impact in pancreatic ductal adenocarcinoma (PDAC) remains unclear and may be influenced by heterogeneous adherence to protocol guidelines. Hence, we investigated the impact of RDI, protocol violations, and center-level protocol adherence on Event Free Survival (EFS). MATERIALS AND METHODS: This is a post hoc exploratory analysis of the preoperative part of the phase III CASSANDRA-PACT21 trial, including 2…

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…

Co-Clinical Evaluation of Synthetic Vitamin D and Chemotherapy in Pancreatic Cancer by Integrated Imaging and Molecular Analyses.

Cancer research communications · 2026 · PMID 42574460

PURPOSE: A pilot clinical trial (NCT03519308) was conducted to evaluate perioperative chemotherapy [nab-paclitaxel, gemcitabine, and cisplatin (NGC)] plus nivolumab, with or without synthetic vitamin D (paricalcitol) in resectable pancreatic ductal adenocarcinoma (PDAC). Preclinical studies were designed with statistical power to match the experimental regimen and compare NGC only with NGC plus synthetic vitamin D [calcipotriol (Cal)] or losartan (Losa; an antihypertensive medication). MATERIALS AND METHODS: Molecu…

Development and Crossover Evaluation of an Artificial Intelligence-Assisted System for Solid Pancreatic Lesion Detection and Pancreatic Parenchyma Recognition in Endoscopic Ultrasonography (With Video).

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2026 · PMID 42720264

BACKGROUND AND STUDY AIMS: Pancreatobiliary endoscopic ultrasonography (EUS) is technically demanding, and supervised training opportunities are limited. We developed an artificial intelligence (AI) overlay system for detecting solid pancreatic lesions (SPL) and recognizing pancreatic parenchyma (PP) and evaluated its effect on reader performance. PATIENTS AND METHODS: Across six centers, two deep learning-based models were trained using expert-annotated EUS frames. We then conducted a randomized, two-sequence, two…

Impact of multidimensional health management on postoperative nutrition and mobility in patients undergoing pancreatic tumor surgery.

Nutricion hospitalaria · 2026 · PMID 42125901

Introduction: pancreatic tumors represent a malignant disease of the digestive system. Objective: to evaluate the effectiveness of a cross-dimensional integrated perioperative health management intervention on patients with pancreatic tumors. Methods: a cohort of 112 patients with pancreatic tumors who underwent surgery between January 2023 and April 2025 were selected and randomly assigned in equal numbers to a control group (n = 56) and an intervention group (n = 56) using the random number table method. The cont…

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) …

Effects of Auricular Acupressure on Fatigue, Sleep Quality, Physical Activity, and Quality of Life in Pancreatic Cancer Patients Undergoing Chemotherapy: A Randomized Controlled Trial.

Cancer nursing · 2026 · PMID 40179142

BACKGROUND: Patients with pancreatic cancer exhibit various symptoms and numerous physiological and psychological complications. Therefore, designing intervention measures to alleviate symptoms is crucial. OBJECTIVE: This study explored the effectiveness of a 4-week auricular acupressure intervention for reducing fatigue and improving quality of life, sleep quality, and physical activity in patients receiving chemotherapy for pancreatic cancer. METHODS: This randomized controlled trial was conducted at a medical ce…

Evaluation of Maintenance Capecitabine Therapy After First-Line Chemotherapy in Metastatic Pancreatic Cancer.

Asian Pacific journal of cancer prevention : APJCP · 2026 · PMID 42808386

OBJECTIVE: To assess the clinical impact of maintenance capecitabine following first-line modified FOLFIRINOX in patients with metastatic pancreatic cancer (mPC), focusing on progression-free survival (PFS), overall survival (OS), quality of life (QoL), and the toxicity profile. METHODS: This phase II prospective trial, 60 patients with histologically confirmed stage IV pancreatic adenocarcinoma (ECOG PS ≤1, normal organ function, and measurable metastatic disease) who were enrolled after completing modified FOLFIR…

Dose response relationship of medical cannabis and symptom control in patients with pancreatic cancer: an analysis of the CANPAN trial.

The oncologist · 2026 · PMID 42767994

BACKGROUND: In a pilot waitlist-control randomized trial, a personalized medical cannabis intervention improved certain symptoms among patients with pancreatic cancer over 8 weeks. Longer-term and dose-response data can guide future trial design. METHODS: CANPAN enrolled 32 cannabis-naïve patients with newly diagnosed locally advanced/metastatic pancreatic adenocarcinoma (NCT06605430). Patients were randomized to early (0-8 weeks) or delayed (9-16 weeks) cannabis intervention. Primary efficacy results over the firs…

Second-Line Systemic Therapy Following First-Line FOLFIRINOX or NALIRIFOX in Metastatic Pancreatic Ductal Adenocarcinoma: A Systematic Review and Meta-Analysis.

Journal of gastrointestinal cancer · 2026 · PMID 42804027

PURPOSE: FOLFIRINOX and NALIRIFOX are now preferred first-line treatments for metastatic pancreatic ductal adenocarcinoma (mPDAC), yet optimal second-line therapy after frontline triplet chemotherapy remains unclear. Prior evidence largely addressed second-line treatment after gemcitabine-based first-line therapy, limiting relevance today. We conducted the first contemporary systematic review and meta-analysis of second-line therapy after frontline triplet chemotherapy. METHODS: We searched MEDLINE, Embase, CINAHL,…

Pain response after palliative-intent radiotherapy for pancreatic cancer: a systematic review.

International journal of clinical oncology · 2026 · PMID 42566091

BACKGROUND: To date, no review has specifically focused on palliative-intent radiotherapy (RT) for pancreatic cancer (PC)-related pain. This study aimed to evaluate the pain response after palliative-intent RT for PC-related pain. METHODS: A comprehensive literature search was conducted using PubMed, Ichushi-Web, and the Cochrane Library for studies published between 1971 and 2024. Studies in which palliative-intent RT was administered for PC-related pain were included. Extracted Data were independently assessed by…

Preclinical evidence for cytokine-based immunotherapy in pancreatic cancer treatment: A systematic review.

International journal of biological macromolecules · 2026 · PMID 42431486

Pancreatic cancer remains one of the most lethal malignancies, characterized by a highly immunosuppressive tumor microenvironment (TME) and a dense desmoplastic stroma, representing a significant challenge to immunotherapy application. This systematic review evaluates cytokine-based immunotherapy as a strategy to overcome these barriers. Following PRISMA guidelines, we searched PubMed, SCOPUS, and Web of Science for original preclinical studies published between 2020 and 2025 that evaluated the administration or in…

Endoscopic Ultrasound-Guided Franseen Fine-Needle Biopsy for Solid Pancreatic Lesions: A Systematic Review and Meta-Analysis.

Digestive diseases and sciences · 2026 · PMID 42156629

INTRODUCTION: Accurate tissue acquisition (TA) of solid pancreatic lesions is essential for guiding treatment with endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) being the preferred method. Among FNB designs, the three-pronged Franseen-tip needle demonstrates strong diagnostic performance, though direct head-to-head comparisons with other FNB designs remain limited. METHODOLOGY: This meta-analysis was conducted in accordance with PRISMA guidelines (PROSPERO: CRD420251123856). Eligible studies enrolled pa…

The influence of somatostatin analogues on the incidence of pancreatic fistulas and postoperative morbidity in patients undergoing pancreatic resection: A Bayesian network meta-analysis.

PloS one · 2025 · PMID 40971392

BACKGROUND: Pancreatic resection is a critical treatment for pancreatic cancer and other pancreatic diseases. Somatostatin analogs are commonly used to prevent complications following pancreatic resection, but their efficacy and safety remain debated. METHODS: Following PRISMA guidelines, a systematic search was conducted across multiple databases, including PubMed, EMBASE, Scopus, Cochrane Library, Ovid, ClinicalTrials.gov, Web of Science, CNKI, and WanFang Data. The search focused on studies comparing the use of …

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 …

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…

Efficacy and Safety of Cadonilimab in Digestive System Neoplasms: A Systematic Review and Single-Arm Meta-Analysis.

Pharmaceuticals (Basel, Switzerland) · 2026 · PMID 42797394

Objective: This study aimed to systematically evaluate the efficacy and safety of cadonilimab in the treatment of digestive system neoplasms. Methods: PubMed, Embase, Cochrane Library, Web of Science, Wiley Online Library, CNKI, Wanfang Data, CBM, and VIP databases were systematically searched to collect randomized controlled trials, non-randomized studies, and real-world studies investigating cadonilimab for the treatment of digestive system neoplasms. The initial search spanned from the inception of the databases…

Sweetened Beverages and Pancreatic Cancer: Insights From Recent Epidemiological Data and Oncogenic Mechanisms.

Molecular nutrition & food research · 2026 · PMID 42806724

PURPOSE OF REVIEW: Hyperglycemia and altered carbohydrate metabolism may promote pancreatic cancer cell survival and proliferation. This narrative review critically evaluates epidemiological evidence on whether sugar-sweetened beverage (SSB) consumption is associated with pancreatic cancer risk and examines potential biological mechanisms involving glucose and fructose metabolism, oncogenic KRAS signaling, and metabolic reprogramming. RECENT FINDINGS: Earlier pooled analyses and a 2019 meta-analysis found no signif…

Effect of a MUC5AC Antibody (NPC-1C) Administered With Second-Line Gemcitabine and Nab-Paclitaxel on the Survival of Patients With Advanced Pancreatic Ductal Adenocarcinoma: A Randomized Clinical Trial.

JAMA network open · 2023 · PMID 36602796

IMPORTANCE: Treatment options are limited for patients with advanced pancreatic ductal adenocarcinoma (PDAC) beyond first-line 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX), with such individuals commonly being treated with gemcitabine and nab-paclitaxel. OBJECTIVE: To determine whether NPC-1C, an antibody directed against MUC5AC, might increase the efficacy of second-line gemcitabine and nab-paclitaxel in patients with advanced PDAC. DESIGN, SETTING, AND PARTICIPANTS: This multicenter, rando…

Evaluation of Maintenance Capecitabine Therapy After First-Line Chemotherapy in Metastatic Pancreatic Cancer.

Asian Pacific journal of cancer prevention : APJCP · 2026 · PMID 42808386

OBJECTIVE: To assess the clinical impact of maintenance capecitabine following first-line modified FOLFIRINOX in patients with metastatic pancreatic cancer (mPC), focusing on progression-free survival (PFS), overall survival (OS), quality of life (QoL), and the toxicity profile. METHODS: This phase II prospective trial, 60 patients with histologically confirmed stage IV pancreatic adenocarcinoma (ECOG PS ≤1, normal organ function, and measurable metastatic disease) who were enrolled after completing modified FOLFIR…

Impact of center-level protocol adherence on neoadjuvant treatment outcome in pancreatic ductal adenocarcinoma.

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 42743889

INTRODUCTION: Chemotherapy dose reductions and delays reduce relative dose intensity (RDI) but their prognostic impact in pancreatic ductal adenocarcinoma (PDAC) remains unclear and may be influenced by heterogeneous adherence to protocol guidelines. Hence, we investigated the impact of RDI, protocol violations, and center-level protocol adherence on Event Free Survival (EFS). MATERIALS AND METHODS: This is a post hoc exploratory analysis of the preoperative part of the phase III CASSANDRA-PACT21 trial, including 2…

Intravenous hyaluronidase-expressing oncolytic adenovirus with chemotherapy in metastatic pancreatic cancer: a randomized phase 2b trial.

Nature medicine · 2026 · PMID 42816596

Zabilugene almadenorepvec (VCN-01) is a hyaluronidase-expressing oncolytic adenovirus with a favorable safety profile and encouraging antitumor activity in patients with pancreatic ductal adenocarcinoma. This randomized phase 2b trial evaluated the efficacy and safety of two doses of intravenous VCN-01 with gemcitabine and nab-paclitaxel (GnP) versus GnP alone as first-line therapy in metastatic pancreatic ductal adenocarcinoma. The primary endpoints were overall survival (OS) in the intent-to-treat and full analys…

Intraoperative esketamine for postoperative analgesia and depression in pancreatic cancer surgery: protocol for a multicenter randomized controlled trial.

Annals of medicine · 2026 · PMID 42657795

INTRODUCTION: Patients undergoing pancreatic cancer surgery frequently experience severe postoperative pain and a high prevalence of depression. Esketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, offers rapid-onset analgesic and antidepressant properties, yet its efficacy in this high-risk population remains unknown. We hypothesize that intraoperative esketamine infusion improves multidimensional analgesic benefit and reduces postoperative depression compared with placebo. PATIENTS AND METHODS: This pr…

Daraxonrasib: The first-in-class RAS(ON) multi-selective inhibitor approved for treatment of metastatic pancreatic adenocarcinoma.

Drug discoveries & therapeutics · 2026 · PMID 42802048

Advanced pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis, with limited benefits from conventional chemotherapy. Daraxonrasib is an oral, noncovalent RAS(ON) multi-selective inhibitor that forms a ternary complex with cyclophilin A and GTP-bound RAS, blocking downstream signaling across multiple mutant and wild-type RAS proteins. On August 26, 2026, the US Food and Drug Administration approved daraxonrasib for adults with metastatic pancreatic adenocarcinoma previously treated with systemic therapy or i…

Early postoperative outcomes after hybrid minimally invasive pancreaticoduodenectomy with a mini-laparotomy reconstruction: a single-centre randomised feasibility trial.

Surgical endoscopy · 2026 · PMID 42768115

BACKGROUND: Minimally invasive pancreaticoduodenectomy is being increasingly adopted over the traditional open approach, but this adoption remains limited by a steep learning curve and the need for safe pancreatic and biliary reconstruction. This pilot randomised study evaluated the technical feasibility and safety of our novel hybrid approach, comparing robotic-assisted Whipple's pancreaticoduodenectomy (RAW), laparoscopic-assisted Whipple's pancreaticoduodenectomy (LAW), and open Whipple's pancreaticoduodenectomy…

Endoscopic Ultrasound-Guided Gallbladder Drainage for Malignant Distal Biliary Obstruction: Current Evidence, Technical Considerations, and Future Directions.

Medicina (Kaunas, Lithuania) · 2026 · PMID 42796333

Malignant distal biliary obstruction (MDBO) is most commonly managed by endoscopic retrograde cholangiopancreatography (ERCP) with self-expandable metal stent placement. When ERCP fails or is not feasible, endoscopic ultrasound-guided biliary drainage (EUS-BD) has increasingly replaced percutaneous transhepatic biliary drainage in expert centers. Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) has emerged as an indirect route for biliary decompression when the cystic duct is patent. This comprehensive n…

Personalized neoantigen mRNA vaccines for pancreatic cancer: the role of lipid nanoparticle delivery systems.

Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences · 2026 · PMID 42766065

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy characterized by late diagnosis, frequent recurrence, limited treatment options, and an immunosuppressive tumor microenvironment. These features have encouraged the development of personalized approaches targeting tumor-specific neoantigens. OBJECTIVE: This review discusses the development and therapeutic potential of personalized neoantigen mRNA vaccines for PDAC, with particular emphasis on lipid nanoparticle (LNP) delivery systems an…

Triplet chemotherapy with Gemcitabine, Nab-paclitaxel, and S-1 achieves high response and conversion rates in advanced pancreatic cancer: A multicenter phase II study (GeNeS1S trial).

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 42748587

BACKGROUND: S-1 has demonstrated non-inferiority to gemcitabine (GEM) in overall survival (OS) in advanced pancreatic cancer and superiority in the adjuvant setting for resectable disease. This study evaluated the efficacy and safety of S-1 combined with GEM plus nab-paclitaxel (nPTX) in advanced pancreatic cancer. METHODS: This multicenter, single-arm, phase II study enrolled patients with previously untreated locally advanced, recurrent, or metastatic pancreatic cancer. Treatment consisted of GEM (600 mg/m²) and …

Efficacy and safety of a novel oral anti-vasculogenic mimicry agent, CVM-1118, in advanced well-differentiated neuroendocrine tumors: a Phase IIa trial.

British journal of cancer · 2026 · PMID 42393461

BACKGROUND: Highly vascularised neuroendocrine tumours (NETs) are attractive targets for foslinanib (CVM-1118), which disrupts vasculogenic mimicry and induces apoptosis via tumour necrosis factor receptor-associated protein 1. We evaluated the efficacy and safety of CVM-1118 in advanced NETs. METHODS: Patients with grades 1-2, well-differentiated lung, gastrointestinal, or pancreatic NETs, refractory or intolerant to one or more standard therapies and progressing within 6 months, received CVM-1118 (200-300 mg oral…

Distal pancreatectomy in octogenarians: A comparative analysis of open, laparoscopic, and robotic approaches from an international multicenter cohort.

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2026 · PMID 42617585

BACKGROUND: Evidence comparing surgical approaches for distal pancreatectomy in octogenarians remains limited. This study compared perioperative outcomes of open versus minimally invasive surgery and evaluated laparoscopic versus robotic techniques. METHODS: A multicenter retrospective study involving 39 international centers was conducted, including octogenarian patients who underwent distal pancreatectomy between 2012 and 2025. Open and minimally invasive approaches were compared using propensity score matching (…

Organ-preserving surgery for solid pseudopapillary neoplasm of the pancreas: A multicentric study.

European journal of cancer (Oxford, England : 1990) · 2026 · PMID 42759262

BACKGROUND: Solid pseudopapillary neoplasms (SPNs) are rare, indolent pancreatic tumors characterized by an excellent prognosis, with a predilection for young females. While organ-preserving surgical approaches are gaining traction in clinical practice, the standard treatment for SPNs continues to rely on non-organ-preserving resection techniques-a strategy originally adapted from the management of pancreatic adenocarcinoma, a more aggressive tumor subtype. METHODS: This multicentric study employed a two-cohort des…

11.5-Fr Large-Bore Plastic Stents Versus Fully Covered Self-Expandable Metallic Stents for the Management of Preoperative Endoscopic Biliary Obstruction in Pancreatic Cancer: A Multicenter Retrospective Cohort Study.

Digestive diseases and sciences · 2026 · PMID 42479302

BACKGROUND: Self-expandable metallic stents (SEMSs) are recommended for preoperative biliary drainage in patients with pancreatic cancer. However, they are associated with a relatively high incidence of non-recurrent biliary obstruction (RBO) adverse events (AEs), such as pancreatitis and cholecystitis. The 11.5-Fr large-bore plastic stent (LBPS) is a newly developed stent with a larger diameter than conventional plastic stents. The aim of the present study was to compare the clinical outcomes of LBPS and SEMS in p…

L-Glutamine in combination with first-line gemcitabine and nab-paclitaxel in advanced pancreatic ductal adenocarcinoma: an open-label, single-arm, phase 1 GlutaPanc trial.

Nature cancer · 2026 · PMID 42675216

Exogenous L-glutamine has preclinical antitumor activity although formal clinical translation has not been attempted. We conducted a single-arm phase 1 trial to assess the safety and preliminary efficacy of clinical-grade, US Food and Drug Administration-approved L-glutamine therapy with gemcitabine and nab-paclitaxel (GA) in participants with treatment-naive, advanced pancreatic cancer (n = 16). The primary endpoint was to determine the recommended phase 2 dose (RP2D) by adaptive Bayesian design across standard do…

A Single-Center Retrospective Cohort Review of Pancreatic Cysts and Malignancy in Cystic Fibrosis Lung Transplant Recipients.

Digestive diseases and sciences · 2026 · PMID 42458051

BACKGROUND: Individuals with cystic fibrosis (CF) develop pancreatic cysts and cancer more frequently than the general population, particularly among lung transplant recipients due to long-term immunosuppression. CF lung transplant guidelines address many gastrointestinal malignancies including colorectal cancer, but do not provide recommendations for routine surveillance of the pancreas. AIMS: We aim to highlight the increased risk that CF lung transplant patients face for developing pancreatic cysts and malignanc…

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…

Adjuvant Chemotherapy ± Chemoradiotherapy for Adenocarcinoma of the Pancreatic Head: Results of the Radiotherapy Random Assignment of NRG Oncology/RTOG 0848.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2026 · PMID 42456089

PURPOSE: To assess whether adding fluoropyrimidine sensitized radiotherapy (CXRT) to adjuvant chemotherapy improves overall survival (OS) after curative intent resection of the pancreatic head. METHODS: This was a multicenter, randomized phase III, two step trial. Step 1: gemcitabine versus gemcitabine + erlotinib (previously reported). Step 2: random assignment to sixth chemotherapy cycle ± CXRT after five cycles of step 1 chemotherapy without progression. Outcomes of step 2 random assignment are reported here. As…

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 …

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…

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…

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…

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 …

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…

Development and Crossover Evaluation of an Artificial Intelligence-Assisted System for Solid Pancreatic Lesion Detection and Pancreatic Parenchyma Recognition in Endoscopic Ultrasonography (With Video).

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2026 · PMID 42720264

BACKGROUND AND STUDY AIMS: Pancreatobiliary endoscopic ultrasonography (EUS) is technically demanding, and supervised training opportunities are limited. We developed an artificial intelligence (AI) overlay system for detecting solid pancreatic lesions (SPL) and recognizing pancreatic parenchyma (PP) and evaluated its effect on reader performance. PATIENTS AND METHODS: Across six centers, two deep learning-based models were trained using expert-annotated EUS frames. We then conducted a randomized, two-sequence, two…

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.…

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…

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…

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…

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…

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…

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,…