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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Sep 15, 2015; 7(9): 132-140
Published online Sep 15, 2015. doi: 10.4251/wjgo.v7.i9.132
Adenosquamous carcinoma of the pancreas: Molecular characterization of 23 patients along with a literature review
Erkut Borazanci, Sherri Z Millis, Ron Korn, Haiyong Han, Clifford J Whatcott, Zoran Gatalica, Michael T Barrett, Derek Cridebring, Daniel D Von Hoff
Erkut Borazanci, Daniel D Von Hoff, HonorHealth Research Institute, Virginia G. Piper Cancer Center, Scottsdale, AZ 85258, United States
Erkut Borazanci, Haiyong Han, Clifford J Whatcott, Derek Cridebring, Daniel D Von Hoff, Translational Genomics Research Institute, Phoenix, AZ 85004, United States
Sherri Z Millis, Zoran Gatalica, Caris Life Sciences, Phoenix, AZ 85040, United States
Ron Korn, Imaging Endpoints, Scottsdale, AZ 85258, United States
Michael T Barrett, Mayo Clinic, Scottsdale, AZ 85259, United States
Author contributions: All authors contributed to this paper.
Supported by In part the Lee T. Hanley Fund for Pancreatic Cancer Research.
Conflict-of-interest statement: Sherri Z Millis and Zoran Gatalica are employees with Caris and Daniel D Von Hoff also has a consulting role as Executive Director Caris Life Sciences, Scientific Advisory Board. Dr. Daniel D Von Hoff: Executive Director Caris Life Sciences, Scientific Advisory Board. Dr. Sherri Z Millis: Scientific Program Manager, Bioinformatics at Caris Life Sciences. Dr. Zoran Gatalica: medical director and pathologist at Caris Life Sciences. All remaining authors have declared no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Erkut Borazanci, HonorHealth Research Institute, Virginia G. Piper Cancer Center, 10510 N. 92nd St. Ste 200, Scottsdale, AZ 85258, United States. erkut.borazanci@honorhealth.com
Telephone: +1-480-3231350 Fax: +1-480-3231359
Received: April 3, 2015
Peer-review started: April 3, 2015
First decision: April 27, 2015
Revised: June 26, 2015
Accepted: July 11, 2015
Article in press: July 14, 2015
Published online: September 15, 2015
Processing time: 167 Days and 2.9 Hours
Abstract

Adenosquamous carcinoma of the pancreas (ASCP) is a rare entity. Like adenocarcinoma of the pancreas, overall survival is poor. Characteristics of ASCP include central tumor necrosis, along with osteoclasts and hypercalcemia. Various theories exist as to why this histological subtype exists, as normal pancreas tissue has no benign squamous epithelium. Due to the rarity of this disease, limited molecular analysis has been performed, and those reports indicate unique molecular features of ASCP. In this paper, we characterize 23 patients diagnosed with ASCP through molecular profiling using immunohistochemistry staining, fluorescent in situ hybridization, chromogenic in situ hybridization, and gene sequencing, Additionally, we provide a comprehensive literature review of what is known to date of ASCP. Molecular characterization revealed overexpression in MRP1 (80%), MGMT (79%), TOP2A (75), RRM1 (42%), TOPO1 (42%), PTEN (45%), CMET (40%), and C-KIT (10%) among others. One hundred percent of samples tested were positive for KRAS mutations. This analysis shows heretofore unsuspected leads to be considered for treatments of this rare type of exocrine pancreas cancer. Molecular profiling may be appropriate to provide maximum information regarding the patient’s tumor. Further work should be pursued to better characterize this disease.

Keywords: Adenosquamous carcinoma of the pancreas; Molecular profiling; Review

Core tip: This analysis of 23 adenosquamous carcinoma of the pancreas in light of the reviewed literature highlights the potential to identify novel treatments when using a personalized medicine approach to patient tumor characterization.