ArticleTherapeutic advances in gastroenterology2013
Pancreatic cancer: why is it so hard to treat?
Article in Therapeutic advances in gastroenterology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 191 papers, 5 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
191 citing papers in PubMed, 5 syntheses or guidelines pooled it, 343 citations in OpenAlex.
- Objective response rate targets for recurrent glioblastoma clinical trials based on the historic association between objective response rate and median overall survival.Neuro-oncology · 2023Pooled it
- Physical function in patients with resectable cancer of the pancreas and liver-a systematic review.Journal of cancer survivorship : research and practice · 2020Pooled it
- Pooled it
- A systematic review on metabolomics-based diagnostic biomarker discovery and validation in pancreatic cancer.Metabolomics : Official journal of the Metabolomic Society · 2018Pooled it
- A Systematic Review of the Burden of Pancreatic Cancer in Europe: Real-World Impact on Survival, Quality of Life and Costs.Journal of gastrointestinal cancer · 2015Pooled it
- Safety and activity of the TGFβ receptor I kinase inhibitor galunisertib plus the anti-PD-L1 antibody durvalumab in metastatic pancreatic cancer.Journal for immunotherapy of cancer · 2021Trial
- Quality of Life, Fatigue, and Sleep Problems in Pancreatic Cancer Patients—A Randomized Trial on the Effects of ExerciseDeutsches Arzteblatt international · 2019Trial
- Clonal heterogeneity in human pancreatic ductal adenocarcinoma and its impact on tumor progression.Nature genetics · 2026Article
- Phytochemicals as Multitarget Therapeutics in Pancreatic Cancer: Mechanisms, Clinical Evidence, and Translational Challenges.Phytotherapy research : PTR · 2026Review
- In Vitro and In Silico Assessment of Anticancer Activity of Venom-Derived and Biomimetic Neurotransmitter Inhibitor Pentapeptides.Cell biochemistry and biophysics · 2026Article
- Development of Antibody and Antibody Fragment-Based Radiopharmaceuticals for Cancer Imaging and Therapy.Nuclear medicine and molecular imaging · 2026Review
- Inference of upstream-mutation and metabolomic-signature causality identifies prognostic biomarkers and therapeutic targets in pancreatic cancer.Nature communications · 2026Article
- Octogenarians Undergoing Pancreaticoduodenectomy versus Definitive Radiotherapy for Locoregional Therapy of Pancreatic Ductal Adenocarcinoma: A Nationwide Analysis.Annals of surgical oncology · 2026Article
- Efficacy and Safety Assessment of 5-Fluorouracil, Irinotecan and Oxaliplatin-Loaded Implants in Mouse and Pig Models for Pancreatic Cancer Therapy.Advanced materials (Deerfield Beach, Fla.) · 2026Article
- Effects of Proglumide with Chemotherapy on the Pancreatic Tumor Microenvironment: Phase 1 PROGEM Trial.Pharmaceutics · 2026Article
- Cost-effectiveness analysis of palliative treatment for periampullary cancer: a comparison of surgical and endoscopic approaches.Surgical endoscopy · 2026Article
- Bavachin inhibits cell viability and migration in human pancreatic cancer cells.microPublication biology · 2026Article
- Discovery of a novel RSK2 inhibitor for the treatment of metastatic pancreatic cancer.Journal of enzyme inhibition and medicinal chemistry · 2025Article
- Molecular MRI of Dysregulated Zinc Secretion Detects Pancreatic Ductal Adenocarcinoma and Response to KRASG12D Inhibitor Treatment.Cancer research · 2025Article
- Emerging Therapeutic Approaches to Pancreatic Adenocarcinoma: Advances and Future Directions.Current treatment options in oncology · 2025Review
131 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
No common malignancy is as rapidly and inevitably fatal as pancreatic ductal adenocarcinoma (PDA). This grim fact has driven substantial research efforts into this disease in recent decades. Unfortunately, the investment has yet to result in a meaningful increase in 5-year survival. This has prompted many pancreatic cancer researchers and advocates to redouble their efforts, but also requires one to step back and ask why the previous efforts were lacking and to consider why pancreatic cancer is so difficult to treat. The difficulties are legion. PDA is characterized by an insidious clinical syndrome, but is rarely diagnosed at a time when surgical resection is feasible. We lack markers of early detection and screening programs remain unproven even in high risk populations. The location of the tumor in the retroperitoneum, the advanced age of patients, and the systemic effects of disease limit the options for local therapy. Chemotherapy may provide a small benefit, but most efforts to improve on the current regimens consistently and stubbornly fail in advanced clinical trials. The molecular and cellular features of ductal pancreatic tumors are aggressive and underlay multiple levels of therapeutic resistance. Non-cell-autonomous features including stromal proliferation, reduced vascular density and immune suppression also contribute to therapeutic resistance. Growing awareness of these the fundamental features of PDA has begun to guide ongoing research efforts. Clinical trials are now specifically targeting these tumor properties and actively focusing on the therapeutic implications of tumor stroma. As reviewed here, reflecting on the fundamental question of why pancreatic cancer is so difficult to treat is a necessary and informative exercise that will aid our efforts to improve patient outcomes. These efforts will lead to improvements in clinical trial design, expand our focus to include the molecular and histologic implications of novel treatment paradigms, and ultimately change the lives of our patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.