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From Clinical Standards to Translating Next-Generation Sequencing Research into Patient Care Improvement for Hepatobiliary and Pancreatic Cancers

Centre for Biosystems and Genome Network Medicine, Ioannina University, 45110 Ioannina, Greece
Department of Surgery, Ioannina University Hospital, 45110 Ioannina, Greece
Department of Surgery, ‘G. Hatzikosta’ General Hospital, 45001 Ioannina, Greece
General Hospital of Grevena, 51100 Grevena, Greece
1st Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
Department of Plastic Surgery, Ioannina University School of Medicine, 45110 Ioannina, Greece
Third Department of Surgery, Attikon General Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China
Biomedical Research Foundation of the Academy of Athens (BRFAA), 11527 Athens, Greece
Author to whom correspondence should be addressed.
Academic Editor: Srikumar Chellappan
Int. J. Mol. Sci. 2017, 18(1), 180;
Received: 20 November 2016 / Revised: 19 December 2016 / Accepted: 27 December 2016 / Published: 18 January 2017
(This article belongs to the Special Issue Next-Generation Sequencing for Clinical Application)
Hepatobiliary and pancreatic (HBP) cancers are associated with high cancer-related death rates. Surgery aiming for complete tumor resection (R0) remains the cornerstone of the treatment for HBP cancers. The current progress in the adjuvant treatment is quite slow, with gemcitabine chemotherapy available only for pancreatic ductal adenocarcinoma (PDA). In the advanced and metastatic setting, only two targeted drugs have been approved by the Food & Drug Administration (FDA), which are sorafenib for hepatocellular carcinoma and erlotinib for PDA. It is a pity that multiple Phase III randomized control trials testing the efficacy of targeted agents have negative results. Failure in the development of effective drugs probably reflects the poor understanding of genome-wide alterations and molecular mechanisms orchestrating therapeutic resistance and recurrence. In the post-ENCODE (Encyclopedia of DNA Elements) era, cancer is referred to as a highly heterogeneous and systemic disease of the genome. The unprecedented potential of next-generation sequencing (NGS) technologies to accurately identify genetic and genomic variations has attracted major research and clinical interest. The applications of NGS include targeted NGS with potential clinical implications, while whole-exome and whole-genome sequencing focus on the discovery of both novel cancer driver genes and therapeutic targets. These advances dictate new designs for clinical trials to validate biomarkers and drugs. This review discusses the findings of available NGS studies on HBP cancers and the limitations of genome sequencing analysis to translate genome-based biomarkers and drugs into patient care in the clinic. View Full-Text
Keywords: next-generation sequencing (NGS); clinical implications; hepatobiliary and pancreatic (HBP) cancers next-generation sequencing (NGS); clinical implications; hepatobiliary and pancreatic (HBP) cancers
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Kyrochristos, I.D.; Glantzounis, G.K.; Ziogas, D.E.; Gizas, I.; Schizas, D.; Lykoudis, E.G.; Felekouras, E.; Machairas, A.; Katsios, C.; Liakakos, T.; Cho, W.C.; Roukos, D.H. From Clinical Standards to Translating Next-Generation Sequencing Research into Patient Care Improvement for Hepatobiliary and Pancreatic Cancers. Int. J. Mol. Sci. 2017, 18, 180.

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