Molecular landscape of pancreatic cancer: implications for current clinical trials
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Gregory M. Heestand1, Razelle Kurzrock1
1Center for Personalized Cancer Therapy, Division of Hematology and Oncology, University of California, San Diego, La Jolla, California, 92093, U.S.A
Gregory M. Heestand, e-mail: email@example.com
Keywords: Pancreatic Cancer, Targeted Therapy, Biomarker Stratification
Received: December 16, 2014 Accepted: December 17, 2014 Published: February 24, 2015
Despite recent improvements, overall survival for advanced adenocarcinoma of the pancreas continues to be poor. In comparison to other tumor types that have enjoyed marked survival benefit by targeting aberrant cell signaling pathways, standard of care treatment for pancreatic cancer is limited to conventional cytotoxic chemotherapy. Multiple pathway aberrations have been documented in pancreatic cancer. A review of the COSMIC database reveals that most pancreatic cancers contain somatic mutations, with the five most frequent being KRAS, TP53, CDKN2A, SMAD4, and ARID1A, and multiple other abnormalities seen including, but not limited to, mutations in STK11/LKB1, FBXW7, PIK3CA, and BRAF. In the era of tumor profiling, these aberrations may provide an opportunity for new therapeutic approaches. Yet, searching clinicaltrials.gov for recent drug intervention trials for pancreatic adenocarcinoma, remarkably few (10 of 116 (8.6%)) new study protocols registered in the last three years included a molecular/biomarker stratification strategy. Enhanced efforts to target subsets of patients with pancreatic cancer in order to optimize therapy benefit are warranted.
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