{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T02:53:30Z","timestamp":1792724010960,"version":"4.5.0"},"reference-count":110,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"funding contribution from Dr. Sakashi Singal"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Pancreatic ductal adenocarcinoma (PDAC) remains a formidable malignancy with rising incidence and dismal long-term survival, largely due to late-stage presentation and intrinsic resistance to therapy. Recent advances in the multidisciplinary management of PDAC have reshaped treatment paradigms across disease stages. For localized disease, innovations in surgical techniques and the adoption of neoadjuvant strategies have improved resection rates and survival outcomes. In metastatic settings, multiagent chemotherapy regimens and precision therapies targeting BRCA mutations and rare gene fusions are expanding treatment options. Immunotherapeutic modalities, including checkpoint inhibitors, adoptive cell therapies, and mRNA vaccines, show emerging promise despite PDAC\u2019s traditionally immunosuppressive microenvironment. This review synthesizes the current evidence on established therapies and critically evaluates novel and investigational approaches poised to redefine the therapeutic landscape of pancreatic cancer.<\/jats:p>","DOI":"10.3390\/ijms26157055","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T15:00:42Z","timestamp":1753196442000},"page":"7055","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Advances in the Management of Pancreatic Cancer: Current Strategies and Emerging Therapies"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3895-9474","authenticated-orcid":false,"given":"Supriya","family":"Peshin","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Norton Community Hospital, Norton, VA 24273, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9062-9761","authenticated-orcid":false,"given":"Ehab","family":"Takrori","sequence":"additional","affiliation":[{"name":"College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3955-9720","authenticated-orcid":false,"given":"Naga Anvesh","family":"Kodali","sequence":"additional","affiliation":[{"name":"Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9634-613X","authenticated-orcid":false,"given":"Faizan","family":"Bashir","sequence":"additional","affiliation":[{"name":"School of Medicine, Shiraz University of Medical Sciences, Shiraz 71348-45794, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakshi","family":"Singal","sequence":"additional","affiliation":[{"name":"Department of Hematology & Oncology, East Tennessee State University, Johnson City, TN 37614, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.canlet.2021.06.027","article-title":"Advances in the epidemiology of pancreatic cancer: Trends, risk factors, screening, and prognosis","volume":"520","author":"Cai","year":"2021","journal-title":"Cancer Lett."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Ushio, J., Kanno, A., Ikeda, E., Ando, K., Nagai, H., Miwata, T., Kawasaki, Y., Tada, Y., Yokoyama, K., and Numao, N. 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