complexity of pancreatic ductal cancers and multidimensional strategies for therapeutic targeting

• Published in: The Journal of pathology Vol. 223; no. 2; pp. 296 - 307
• Main Authors: Kern, Scott E, Shi, Chanjuan, Hruban, Ralph H
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01-01-2011
• Subjects: Antineoplastic Agents - therapeutic use; carcinoma; Carcinoma, Pancreatic Ductal - classification; Carcinoma, Pancreatic Ductal - drug therapy; Carcinoma, Pancreatic Ductal - genetics; gene; Gene Expression Regulation, Neoplastic; genetic; heterogeneity; Humans; Molecular Targeted Therapy - methods; Mutation; pancreas; Pancreatic Neoplasms - classification; Pancreatic Neoplasms - drug therapy; Pancreatic Neoplasms - genetics; personalized treatment; Precancerous Conditions - genetics; therapy
• ISSN: 0022-3417; 1096-9896
• DOI: 10.1002/path.2813

The directions of differentiation and the molecular features of ductal pancreatic cancer have by now been explored in reasonable detail. Already, diagnoses and therapeutic strategies benefit from observations distinguishing the major variant types of pancreatic cancer and the differing stages of disease at presentation. Additionally, individual patients differ within each variant type. In certain high-risk groups, this permits focused screening efforts. The tumorigenic influences that characterize individual patients are increasingly considered appropriate in defining clinical treatment plans. As a result, multiple variables affect success when individualizing screening or therapy. These competing variables often limit the potential for success: some variables dominate and should receive greater consideration than others. Simplistic expectations, often falsely optimistic, for individualized care may fail to ‘pan out' in the real world. The development of individualized care will be efficient only when the full complexity of the disease is embraced. Copyright © 2010 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.