Recent Advances and Future Challenges in Pancreatic Cancer Care: Early Detection, Liquid Biopsies, Precision Medicine and Artificial Intelligence

Overview

Journal J Clin Med

Specialty General Medicine

Date 2023 Dec 9

PMID 38068536

Authors

Lois A Daamen

I Quintus Molenaar

Vincent P Groot

Affiliations

Soon will be listed here.

Abstract

The incidence of pancreatic ductal adenocarcinoma (PDAC) is rising. While surgical techniques and peri-operative care have improved, the overall survival for PDAC remains poor. Thus, novel and bold research initiatives are needed along the spectrum of clinical care, a few of which will be discussed in this article. Early detection is crucial, with specific high-risk groups possibly benefiting from targeted screening programs. Liquid biopsies (such as circulating exosomes, tumor DNA, or tumor cells) offer promise as multifunctional biomarkers for early detection, treatment guidance, and recurrence monitoring. Precision medicine is being explored via targeted therapies for actionable mutations, such as PARP inhibitors for BRCA mutations, and immunotherapy strategies. Artificial intelligence (AI) is emerging as a powerful tool in medical imaging, biomarker discovery, genetics research, and treatment planning, and it can aid in diagnosis, treatment selection, and patient monitoring. However, its associated challenges include ethics, data security, algorithm reliability, and validation. Collaborative efforts between medical professionals, researchers, and AI experts are vital for unlocking AI's potential to enhance pancreatic cancer care. In conclusion, despite the challenges, advancements in liquid biopsies, precision medicine, and AI offer hope for enhancing the diagnosis, treatment, and management of pancreatic cancer.

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References

Hosein A, Dougan S, Aguirre A, Maitra A . Translational advances in pancreatic ductal adenocarcinoma therapy. Nat Cancer. 2022; 3(3):272-286. DOI: 10.1038/s43018-022-00349-2. View

Pishvaian M, Blais E, Brody J, Lyons E, DeArbeloa P, Hendifar A . Overall survival in patients with pancreatic cancer receiving matched therapies following molecular profiling: a retrospective analysis of the Know Your Tumor registry trial. Lancet Oncol. 2020; 21(4):508-518. PMC: 7453743. DOI: 10.1016/S1470-2045(20)30074-7. View

Mukherjee S, Patra A, Khasawneh H, Korfiatis P, Rajamohan N, Suman G . Radiomics-based Machine-learning Models Can Detect Pancreatic Cancer on Prediagnostic Computed Tomography Scans at a Substantial Lead Time Before Clinical Diagnosis. Gastroenterology. 2022; 163(5):1435-1446.e3. DOI: 10.1053/j.gastro.2022.06.066. View

Cohen J, Javed A, Thoburn C, Wong F, Tie J, Gibbs P . Combined circulating tumor DNA and protein biomarker-based liquid biopsy for the earlier detection of pancreatic cancers. Proc Natl Acad Sci U S A. 2017; 114(38):10202-10207. PMC: 5617273. DOI: 10.1073/pnas.1704961114. View

Young A, Lyons J, Miller A, Phan V, Alarcon I, McCormick F . Ras signaling and therapies. Adv Cancer Res. 2009; 102:1-17. DOI: 10.1016/S0065-230X(09)02001-6. View

Saba H, Goggins M . Familial Pancreatic Cancer. Gastroenterol Clin North Am. 2022; 51(3):561-575. PMC: 11095833. DOI: 10.1016/j.gtc.2022.06.006. View

Husain H, Velculescu V . Cancer DNA in the Circulation: The Liquid Biopsy. JAMA. 2017; 318(13):1272-1274. PMC: 5819336. DOI: 10.1001/jama.2017.12131. View

Javed A, Floortje van Oosten A, Habib J, Hasanain A, Kinny-Koster B, Gemenetzis G . A Delay in Adjuvant Therapy Is Associated With Worse Prognosis Only in Patients With Transitional Circulating Tumor Cells After Resection of Pancreatic Ductal Adenocarcinoma. Ann Surg. 2022; 277(6):866-872. DOI: 10.1097/SLA.0000000000005710. View

Biankin A, Maitra A . Subtyping Pancreatic Cancer. Cancer Cell. 2015; 28(4):411-413. DOI: 10.1016/j.ccell.2015.09.020. View

10.

Marchegiani G, Pollini T, Burelli A, Han Y, Jung H, Kwon W . Surveillance for Presumed BD-IPMN of the Pancreas: Stability, Size, and Age Identify Targets for Discontinuation. Gastroenterology. 2023; 165(4):1016-1024.e5. PMC: 10548445. DOI: 10.1053/j.gastro.2023.06.022. View

11.

Hecht J, Lonardi S, Bendell J, Sim H, Macarulla T, Lopez C . Randomized Phase III Study of FOLFOX Alone or With Pegilodecakin as Second-Line Therapy in Patients With Metastatic Pancreatic Cancer That Progressed After Gemcitabine (SEQUOIA). J Clin Oncol. 2021; 39(10):1108-1118. PMC: 8078437. DOI: 10.1200/JCO.20.02232. View

12.

Cameron J, He J . Two thousand consecutive pancreaticoduodenectomies. J Am Coll Surg. 2015; 220(4):530-6. DOI: 10.1016/j.jamcollsurg.2014.12.031. View

13.

Gemenetzis G, Groot V, Yu J, Ding D, Teinor J, Javed A . Circulating Tumor Cells Dynamics in Pancreatic Adenocarcinoma Correlate With Disease Status: Results of the Prospective CLUSTER Study. Ann Surg. 2018; 268(3):408-420. DOI: 10.1097/SLA.0000000000002925. View

14.

Raufi A, May M, Hadfield M, Seyhan A, El-Deiry W . Advances in Liquid Biopsy Technology and Implications for Pancreatic Cancer. Int J Mol Sci. 2023; 24(4). PMC: 9958987. DOI: 10.3390/ijms24044238. View

15.

Bernard V, Kim D, San Lucas F, Castillo J, Allenson K, Mulu F . Circulating Nucleic Acids Are Associated With Outcomes of Patients With Pancreatic Cancer. Gastroenterology. 2018; 156(1):108-118.e4. PMC: 6434712. DOI: 10.1053/j.gastro.2018.09.022. View

16.

Schuurmans M, Alves N, Vendittelli P, Huisman H, Hermans J . Artificial Intelligence in Pancreatic Ductal Adenocarcinoma Imaging: A Commentary on Potential Future Applications. Gastroenterology. 2023; 165(2):309-316. DOI: 10.1053/j.gastro.2023.04.003. View

17.

Marchegiani G, Salvia R . Guidelines on Pancreatic Cystic Neoplasms: Major Inconsistencies With Available Evidence and Clinical Practice- Results From an International Survey. Gastroenterology. 2021; 160(7):2234-2238. DOI: 10.1053/j.gastro.2021.02.026. View

18.

Haeberle L, Schramm M, Goering W, Frohn L, Driescher C, Hartwig W . Molecular analysis of cyst fluids improves the diagnostic accuracy of pre-operative assessment of pancreatic cystic lesions. Sci Rep. 2021; 11(1):2901. PMC: 7858638. DOI: 10.1038/s41598-021-81065-2. View

19.

Soreide K, Ismail W, Roalso M, Ghotbi J, Zaharia C . Early Diagnosis of Pancreatic Cancer: Clinical Premonitions, Timely Precursor Detection and Increased Curative-Intent Surgery. Cancer Control. 2023; 30:10732748231154711. PMC: 9893084. DOI: 10.1177/10732748231154711. View

20.

Daamen L, Groot V, Heerkens H, Intven M, van Santvoort H, Molenaar I . Systematic review on the role of serum tumor markers in the detection of recurrent pancreatic cancer. HPB (Oxford). 2018; 20(4):297-304. DOI: 10.1016/j.hpb.2017.11.009. View