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The Evolving Understanding of the Molecular and Therapeutic Landscape of Pancreatic Ductal Adenocarcinoma

1
The Kinghorn Cancer Centre, The Garvan Institute of Medical Research, 384 Victoria St, Darlinghurst, Sydney, NSW 2010, Australia
2
University of Sydney, Sydney, NSW 2006, Australia
3
Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW 2145, Australia
4
Department of Surgery, Royal North Shore Hospital, St Leonards, Sydney, NSW 2065, Australia
5
Department of Anatomical Pathology, Royal North Shore Hospital, St Leonards, Sydney, NSW 2065, Australia
6
Cancer Diagnosis and Pathology Research Group, Kolling Institute of Medical Research, St Leonards, NSW 2065, Australia
7
St Vincent’s Clinical School, Faculty of Medicine, University of NSW, Sydney, NSW 2010, Australia
*
Author to whom correspondence should be addressed.
Diseases 2018, 6(4), 103; https://doi.org/10.3390/diseases6040103
Received: 11 October 2018 / Revised: 7 November 2018 / Accepted: 8 November 2018 / Published: 13 November 2018
(This article belongs to the Special Issue Pathogenesis of Pancreatic Cancer)
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PDF [938 KB, uploaded 13 November 2018]
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Abstract

Pancreatic cancer is the third leading cause of cancer-related deaths, characterised by poor survival, marked molecular heterogeneity and high intrinsic and acquired chemoresistance. Only 10–20% of pancreatic cancer patients present with surgically resectable disease and even then, 80% die within 5 years. Our increasing understanding of the genomic heterogeneity of cancer suggests that the failure of definitive clinical trials to demonstrate efficacy in the majority of cases is likely due to the low proportion of responsive molecular subtypes. As a consequence, novel treatment strategies to approach this disease are urgently needed. Significant developments in the field of precision oncology have led to increasing molecular stratification of cancers into subtypes, where individual cancers are selected for optimal therapy depending on their molecular or genomic fingerprint. This review provides an overview of the current status of clinically used and emerging treatment strategies, and discusses the advances in and the potential for the implementation of precision medicine in this highly lethal malignancy, for which there are currently no curative systemic therapies. View Full-Text
Keywords: pancreatic cancer; tailored therapy; molecular classification; clinical trials pancreatic cancer; tailored therapy; molecular classification; clinical trials
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Parkin, A.; Man, J.; Chou, A.; Nagrial, A.M.; Samra, J.; Gill, A.J.; Timpson, P.; Pajic, M. The Evolving Understanding of the Molecular and Therapeutic Landscape of Pancreatic Ductal Adenocarcinoma. Diseases 2018, 6, 103.

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