Precision oncology for pancreatic cancer in real-world settings

Many reasons exist for this problem: first, a rapidly progressive disease, mandating early induction of systemic therapy if at all possible; second, a relatively low number of actionable genetic variations; and third, disappointing results of the vast majority of trials assessing targeted approaches...

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Bibliographic Details
Published in:The lancet oncology 2020-04, Vol.21 (4), p.469-471
Main Authors: Kleeff, Jörg, Michalski, Christoph W
Format: Article
Language:English
Subjects:
Adenocarcinoma
Cancer therapies
Chemotherapy
Clinical trials
Genetic diversity
Oncology
Pancreatic cancer
Platinum
Poly(ADP-ribose)
Poly(ADP-ribose) polymerase
Precision medicine
Ribose
Tumors
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Summary:Many reasons exist for this problem: first, a rapidly progressive disease, mandating early induction of systemic therapy if at all possible; second, a relatively low number of actionable genetic variations; and third, disappointing results of the vast majority of trials assessing targeted approaches in a general population of patients with pancreatic ductal adenocarcinoma.1 In The Lancet Oncology, Michael Pishvaian and colleagues2 report on the effect of the Know Your Tumor (KYT) programme3 on pancreatic cancer treatment and outcomes in more than 1000 patients. Of note, the authors restricted the analysis of matched therapies in DDR-deficient tumours to poly(ADP-ribose) polymerase (PARP) and ATR inhibitors (and excluded platinum-based therapies). [...]studies in these patient cohorts will most likely be difficult to do, mainly because of the already available effective adjuvant therapies.4 In a stepwise approach, there will be a need for a thorough, prospective investigation of the molecular alteration patterns in different groups of patients from different regions of the world, probably also using different technical approaches.
ISSN:1470-2045
1474-5488
DOI:10.1016/S1470-2045(20)30148-0