Pancreatic ductal adenocarcinoma (PDAC) is projected to be the second cause of cancer death in the world by 2030. Moreover, an increasing number of pancreatic neuroendocrine tumors (PanNETs) and cysts are incidentally discovered for the widespread use of cross-sectional imaging. Therefore, physicians are called to deal with a huge number of pancreatic lesions with different prognosis and management. In this setting, precise diagnosis and prognostic stratification are essential for an appropriate decision-making process. In the last decade, genome-wide analyses of PDAC, PanNETs, and cystic lesions have redefined the taxonomy of these diseases and paved the way for the use of molecular classifications and targets in the routine clinical management of patients. The recent innovations in endoscopic-ultrasound (EUS)-guided tissue acquisition have not only improved the diagnostic yield but also provided appropriate materials for molecular characterization of the tumor biology.
Preliminary results suggested that such “personalized medicine” information without a need for surgery allows accurate prognostication, better treatment stratification, and potentially, improves outcomes for all patients with PDAC. Similarly, the EUS approach has recently enabled the integration of molecular analysis in the assessment of patients with pancreatic cysts and PanNETs, and its impact on clinical outcomes required further evaluation. The analogy to the current concept of a clinical multi-disciplinary approach, where the involvement of a number of specialists in the area can optimize the clinical treatment and outcome of the patients, better characterization of the cancer based on its biological signatures is essential to guide targeted therapies.
In this Frontiers in Medicine Research Topic our goal is to review the current progress in molecular diagnostics and its impact on the decision-making process and therapeutic implications in patients with PDAC, PanNETs, and pancreatic cysts. Given the concept of “personalized oncology” can only be achieved by the availability of appropriate, good quality tissue, approaches of tissue acquisition and preparation from the pancreas will be critical for its success. Specifically, the sampling tools and techniques from the pancreas, methods of tissue preparation, storage and process, and different types of molecular analysis will be discussed in detail. In addition, data on the utility of these molecular analyses on prognostication, treatment stratification, and potential new therapeutic target development will be reviewed and discussed.
We welcome manuscripts in Frontiers in Medicine accepted formats, including original research, systematic reviews, reviews, mini-reviews, perspectives, clinical trials, and case reports. This Research Topic will cover a selection of recent research and current review articles in patients with PDAC, PanNETs, and pancreatic cysts. Specific themes, in particular, but not exclusively, will be:
Endoscopic ultrasound-guided tissue acquisition for molecular diagnostics purpose
New molecular findings and clinical implications
Implications of molecular specificities and prognostic stratification on patient management
New drugs for personalized treatment of PDAC and PanNETs
Pancreatic ductal adenocarcinoma (PDAC) is projected to be the second cause of cancer death in the world by 2030. Moreover, an increasing number of pancreatic neuroendocrine tumors (PanNETs) and cysts are incidentally discovered for the widespread use of cross-sectional imaging. Therefore, physicians are called to deal with a huge number of pancreatic lesions with different prognosis and management. In this setting, precise diagnosis and prognostic stratification are essential for an appropriate decision-making process. In the last decade, genome-wide analyses of PDAC, PanNETs, and cystic lesions have redefined the taxonomy of these diseases and paved the way for the use of molecular classifications and targets in the routine clinical management of patients. The recent innovations in endoscopic-ultrasound (EUS)-guided tissue acquisition have not only improved the diagnostic yield but also provided appropriate materials for molecular characterization of the tumor biology.
Preliminary results suggested that such “personalized medicine” information without a need for surgery allows accurate prognostication, better treatment stratification, and potentially, improves outcomes for all patients with PDAC. Similarly, the EUS approach has recently enabled the integration of molecular analysis in the assessment of patients with pancreatic cysts and PanNETs, and its impact on clinical outcomes required further evaluation. The analogy to the current concept of a clinical multi-disciplinary approach, where the involvement of a number of specialists in the area can optimize the clinical treatment and outcome of the patients, better characterization of the cancer based on its biological signatures is essential to guide targeted therapies.
In this Frontiers in Medicine Research Topic our goal is to review the current progress in molecular diagnostics and its impact on the decision-making process and therapeutic implications in patients with PDAC, PanNETs, and pancreatic cysts. Given the concept of “personalized oncology” can only be achieved by the availability of appropriate, good quality tissue, approaches of tissue acquisition and preparation from the pancreas will be critical for its success. Specifically, the sampling tools and techniques from the pancreas, methods of tissue preparation, storage and process, and different types of molecular analysis will be discussed in detail. In addition, data on the utility of these molecular analyses on prognostication, treatment stratification, and potential new therapeutic target development will be reviewed and discussed.
We welcome manuscripts in Frontiers in Medicine accepted formats, including original research, systematic reviews, reviews, mini-reviews, perspectives, clinical trials, and case reports. This Research Topic will cover a selection of recent research and current review articles in patients with PDAC, PanNETs, and pancreatic cysts. Specific themes, in particular, but not exclusively, will be:
Endoscopic ultrasound-guided tissue acquisition for molecular diagnostics purpose
New molecular findings and clinical implications
Implications of molecular specificities and prognostic stratification on patient management
New drugs for personalized treatment of PDAC and PanNETs