Reshaping preoperative treatment of pancreatic cancer in the era of precision medicine

R Casolino; C Braconi; G Malleo; S Paiella; C Bassi; M Milella; S B Dreyer; F E M Froeling; D K Chang; A V Biankin; T Golan

doi:10.1016/j.annonc.2020.11.013

Reshaping preoperative treatment of pancreatic cancer in the era of precision medicine

Ann Oncol. 2021 Feb;32(2):183-196. doi: 10.1016/j.annonc.2020.11.013. Epub 2020 Nov 26.

Authors

R Casolino¹, C Braconi², G Malleo³, S Paiella³, C Bassi³, M Milella⁴, S B Dreyer⁵, F E M Froeling⁶, D K Chang⁵, A V Biankin⁷, T Golan⁸

Affiliations

¹ Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Bearsden, Glasgow, Scotland, UK; Department of Medicine, University and Hospital Trust of Verona, Verona, Italy.
² Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Bearsden, Glasgow, Scotland, UK.
³ Department of Surgery, University and Hospital Trust of Verona, Verona, Italy.
⁴ Department of Medicine, Medical Oncology, University and Hospital Trust of Verona, Verona (VR), Italy.
⁵ Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Bearsden, Glasgow, Scotland, UK; West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, UK.
⁶ Edinburgh Cancer Centre, Western General Hospital, NHS Lothian, Edinburgh, UK.
⁷ Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Bearsden, Glasgow, Scotland, UK; West of Scotland Pancreatic Unit, Glasgow Royal Infirmary, Glasgow, UK; South Western Sydney Clinical School, Faculty of Medicine, University of NSW, Liverpool, NSW, Australia. Electronic address: andrew.biankin@glasgow.ac.uk.
⁸ Oncology Institute, Sheba Medical Center, Tel Hashomer, Israel.

Abstract

This review summarises the recent evidence on preoperative therapeutic strategies in pancreatic cancer and discusses the rationale for an imminent need for a personalised therapeutic approach in non-metastatic disease. The molecular diversity of pancreatic cancer and its influence on prognosis and treatment response, combined with the failure of 'all-comer' treatments to significantly impact on patient outcomes, requires a paradigm shift towards a genomic-driven approach. This is particularly important in the preoperative, potentially curable setting, where a personalised treatment allocation has the substantial potential to reduce pancreatic cancer mortality.

Keywords: Pancreatic cancer; neoadjuvant; precision medicine; predictive biomarkers; preoperative; prognostic biomarkers.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Biomarkers, Tumor / genetics
Humans
Neoadjuvant Therapy
Pancreatic Neoplasms* / surgery
Precision Medicine*
Prognosis

Substances

Biomarkers, Tumor

Abstract

Publication types

MeSH terms

Substances

Grants and funding