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Comprehensive review of undifferentiated carcinoma of the pancreas: from epidemiology to treatment.

ABSTRACT: Undifferentiated carcinoma (UC) of the pancreas is a rare subtype of pancreatic cancer displaying no definitive direction of differentiation. UC has been reported as a highly aggressive malignant neoplasm, with a median overall survival of <1 year, except for several surgical series. On the other hand, UC tissue sometimes contains non-neoplastic osteoclast-like giant cells (OGCs), and such cases have been reported to have relatively longer survival. Thus, the World Health Organization (WHO) classification histologically distinguishes UC with OGCs (UCOGCs) from UC, and UCs were subclassified into three subtypes: anaplastic UC, sarcomatoid UC and carcinosarcoma. However, still less is known about UC due to its rarity, and such situations lead to further difficulties in treatment for UC. To date, only surgical resection can offer curative treatment for patients with UC, and no clear evidence for chemotherapy exists for them. However, a retrospective cohort study and case reports showed that relatively promising results paclitaxel-containing regimens for treatment of patients with unresectable UC. Furthermore, high programmed cell death protein 1 expression has been reported in sarcomatoid UCs and UCOGCs, and promising responses to anti-programmed death-ligand 1 therapy have been described in case reports of UCOGCs. Recent advances in chemotherapeutic agents and molecular technologies are opening up the possibilities for expanded treatments.

SUBMITTER: Imaoka H

PROVIDER: S-EPMC10473279 | biostudies-literature | 2023 Aug

REPOSITORIES: biostudies-literature

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Comprehensive review of undifferentiated carcinoma of the pancreas: from epidemiology to treatment.

Imaoka Hiroshi H Ikeda Masafumi M Umemoto Kumiko K Sunakawa Yu Y Ueno Makoto M Ueno Hideki H Ozaka Masato M Kuwahara Takamichi T Okano Naohiro N Kanai Masashi M Hisano Terumasa T Suzuki Yuko Y Asagi Akinori A Shioji Kazuhiko K Todaka Akiko A Tsuji Kunihiro K Ikezawa Kenji K Miki Ikuya I Komatsu Yoshito Y Akutsu Noriyuki N Yamashita Tatsuya T Okuyama Hiroyuki H Furuse Junji J Nagano Hiroaki H

Japanese journal of clinical oncology 20230801 9

Undifferentiated carcinoma (UC) of the pancreas is a rare subtype of pancreatic cancer displaying no definitive direction of differentiation. UC has been reported as a highly aggressive malignant neoplasm, with a median overall survival of <1 year, except for several surgical series. On the other hand, UC tissue sometimes contains non-neoplastic osteoclast-like giant cells (OGCs), and such cases have been reported to have relatively longer survival. Thus, the World Health Organization (WHO) clas ...[more]

PMID: 37325968

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Project description:Background and objectiveUndifferentiated carcinoma of the pancreas with osteoclast-like giant cells (UCOGC) is a rare variant of malignant pancreatic tumor. There is still no standardized treatment for this uncommon subtype, as surgical resection with lymphadenectomy is the only potentially curative treatment so far. In this paper, we describe the current knowledge of this very rare specific subtype of pancreatic cancer (PC) as a narrative review.MethodsFor this review, we did not specify the time range of studies referred to due to limited data availability. Our inclusion criteria comprised previous studies, which specifically focused on the rare UCOGC subtype of PC as a confirmed histopathology, either pure or present together with other subtypes. We disregarded the studies involving any other PC subtype but not UCOGC, including undifferentiated and anaplastic carcinomas without osteoclast-like giant cell components.Key content and findingsThe limited available data precludes a definitive assessment of the efficacy of both neoadjuvant and adjuvant chemotherapy in the treatment of UCOGC. Monoclonal antibody pembrolizumab has been proven to be effective in metastatic cases. Multiple cases demonstrate a better overall survival rate for patients with UCOGC only versus those having UCOGC as a component with a pancreatic ductal adenocarcinoma (PDAC) histopathological subtype. The same conclusion can be also drawn comparing the survival rate of patients having pure UCOGC versus UCOGC with associated PDAC. Programmed cell death ligand-1 expression has been shown to be an important determinant, which shortens the survival period of patients diagnosed with UCOGC.ConclusionsThe rarity of UCOGC limits data for clinical courses and treatment plans. We need more data to better understand the relationship between pathogenic mutations, histological subtypes, and prognosis in PC, including UCOGC. Understanding UCOGC's molecular, clinical, radiological, and pathological characteristics can lead to earlier, more accurate diagnoses and better management.

Dataset Information

Comprehensive review of undifferentiated carcinoma of the pancreas: from epidemiology to treatment.

Publications

Comprehensive review of undifferentiated carcinoma of the pancreas: from epidemiology to treatment.

Similar Datasets

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