Pancreas adenocarcinoma remains a very challenging malignancy with a rising incidence globally and in particular in western countries such as the United States, and China. It is an unrecognized public health problem and despite recent significant improvements in outcomes for many other major solid organ malignancies, such benefits have yet to be witnessed for pancreas ductal adenocarcinoma. Nonetheless major improvements in understanding regarding the genomic make up of this disease along with a recognition of the critical importance of the tumor microenvironment and the immunologic milieu of this disease, have significantly improved our understanding and let to insights regarding new avenues of pre-clinical, translational and clinical research. In this special issue of the Chinese Clinical Oncology journal we are proud to introduce the first of two issues centered on the current state of the art for pancreas ductal adenocarcinoma. Contributions from major centers and individuals focused on this disease provide key insights. This special issue is designed to be meaningful and useful to a general reader along with providing an in-depth focus for individuals with a particular interest in a sub-topic of this disease.
The first of the two manuscripts includes a summary of model systems for pancreatic adenocarcinoma. Such models are of acute importance to provide opportunity for understanding biology, genomics and providing a personalized tool for ex-vivo drug assessment.
Moving to clinical aspects of pancreatic adenocarcinoma, concise reviews centered on the epidemiology and clinical genetic considerations, adjuvant and neoadjuvant therapy for localized pancreas adenocarcinoma, the role of radiation and optimal practices for advanced disease, are included. In addition, comprehensive summaries on novel therapeutics with a focus on DNA repair, stromal disruption and cancer stem cell targeting and a separate article outlining the seminal issues pertaining to immune function and where immunologic strategies fit in this disease, all of which collectively speak to the current and proximate future in pancreas adenocarcinoma and highlight areas of potential promise.