Topic Highlight
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World J Gastroenterol. Aug 21, 2014; 20(31): 10769-10777
Published online Aug 21, 2014. doi: 10.3748/wjg.v20.i31.10769
Translational research in pancreatic ductal adenocarcinoma: Current evidence and future concepts
Stephan Kruger, Michael Haas, Steffen Ormanns, Sibylle Bächmann, Jens T Siveke, Thomas Kirchner, Volker Heinemann, Stefan Boeck
Stephan Kruger, Michael Haas, Sibylle Bächmann, Volker Heinemann, Stefan Boeck, Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, D-81377 Munich, Germany
Steffen Ormanns, Sibylle Bächmann, Thomas Kirchner, Department of Pathology, Ludwig-Maximilians-University of Munich, 80377 Munich, Germany
Jens T Siveke, Department of Internal Medicine II, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany
Author contributions: Kruger S and Boeck S wrote the manuscript; Haas M, Ormanns S, Bächmann S, Siveke JT, Kirchner T and Heinemann V critically reviewed and revised the manuscript; all authors read and approved the final version of the manuscript.
Correspondence to: Dr. Stefan Boeck, Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Marchioninistr. 15, D-81377 Munich, Germany. stefan.boeck@med.uni-muenchen.de
Telephone: +49- 89-70952208 Fax: +49-89-70955256
Received: October 26, 2013
Revised: January 26, 2014
Accepted: April 8, 2014
Published online: August 21, 2014
Abstract

Pancreatic ductal adenocarcinoma (PDA) is one of the major causes for cancer death worldwide. Treatment of metastatic disease remains challenging as only certain patients benefit from advances made with the intensified chemotherapy regimen folinic acid, irinotecan and oxaliplatin, the epidermal growth factor receptor inhibitor erlotinib or the recently FDA-approved nab-paclitaxel. Up to date, no established approach for prediction of treatment response or specific treatment allocation exists. Translational research was able to identify a number of potential biomarkers that might help to improve the dismal prognosis of PDA by facilitating upfront treatment allocation. This topic highlight is focused on current evidence on potential biomarkers for tumor biology, prognosis and prediction of treatment efficacy.

Keywords: Biomarker, Erlotinib, Gemcitabine, Human equilibrative nucleoside transporter 1, KRAS, Nab-paclitaxel, p53, Pancreatic cancer, SMAD4, SPARC

Core tip: Recent advances in the treatment of pancreatic ductal adenocarcinoma (PDA) have been made using the intensified chemotherapy regimen folinic acid, irinotecan and oxaliplatin, the recently FDA-approved nab-paclitaxel and the epidermal growth factor receptor-inhibitor erlotinib. Yet overall prognosis of PDA remains poor. To further improve outcome of PDA, innovative strategies are needed to identify patient subgroups that benefit most from specific regimens. This topic highlight focuses on potential biomarkers to identify patients that benefit from treatment with erlotinib (e.g. KRAS, AKT, ERK, p53), gemcitabine (hENT1, RRM1, dCK), nab-paclitaxel (SPARC) or angiogenesis inhibitors. Additional biomarkers of tumor biology (like SMAD4 and CXCR4) and future concepts of translational research in PDA are also discussed.