<p>Pancreatic cancer in young adults: changes, challenges, and solutions</p>

Abstract

Despite improvements in multidisciplinary treatments, survival of pancreatic cancer (PC) patients remains dismal. Studies dealing with early onset pancreatic cancer (EOPC) patients are scarce. In this review, we discuss differences between EOPC and late-onset pancreatic cancer based on findings in original papers and reviews with a focus on morphology, genetics, clinical outcomes and therapy. In conclusion, families with a positive history of PC and patients with BRCA 1 or 2 mutations should be monitored. Patients with EOPC usually present with better overall fitness compared to the average PC population, however often with even more aggressive cancer behaviour. Therefore, potent state-of-the-art multi-modal systemic therapies should be applied whenever possible. Large-scale registries and randomized clinical trials dealing with EOPC in regard to distinct biology and outcome are warranted.

Epidemiology of Pancreatic Cancer in Saudi Arabia: A Retrospective Analysis of Pancreatic Cancer Diagnosed in Saudi Arabia Between 2004 and 2015

“… 9 It is important to consider patients with early onset pancreatic cancer, as they may be able to undergo more intensive therapy due to their better overall health. 9 …”

Incidence, Survival, and Mortality Trends of Cancers Diagnosed in Adolescents and Young Adults (15–39 Years): A Population-Based Study in The Netherlands 1990–2016

“…Likely also related to therapeutic advances are the improvements in survival among AYAs with lung, liver, pancreas, and stomach carcinomas (more prominent in males) [ 64 , 65 , 66 , 67 ]. Nevertheless, survival outcomes for these cancers in AYAs have remained relatively poor (<60%), which is characteristic for these cancer types regardless of patient age [ 52 , 68 , 69 , 70 , 71 , 72 ].…”

<p>Locally Advanced Pancreatic Ductal Adenocarcinoma: Challenges and Progress</p>

“…Over the years, different molecular classification has been proposed thanks to the introduction of high-throughput techniques and the better knowledge of the pathogenetic role of the PDAC-related genes KRAS, TP53, SMAD4 , and CDKN2A . 66 Based on the molecular characteristics of PDAC, several authors conducted an interesting molecular classification approach that we summarised below. The molecular classification by Collisson et al 67 identified subtypes of PDAC which are different for outcomes and therapeutic response ( Table 3 ): classical, quasi-mesenchymal, and exocrine-like.…”

“…Comparing the gene signatures of the abovementioned classification, it can be observed a non-perfect overlap. As well reported by Primavesi et al 66 several working groups used different terminologies as well as different approaches to define biological-similar subtypes and, the definition of consensus genetic models among different classifications is desirable to find new diagnostic and tailored treatment options.…”

“… 59 Since the number of PanIN associated with high-grade dysplasia is increased in patients with a family history of PDAC, these precursor lesions are hypothesized to occur at a very young age. 66 …”