Molecular subtypes of pancreatic cancer

Cancers that appear morphologically similar often have dramatically different clinical features, respond variably to therapy and have a range of outcomes. Compelling evidence now demonstrates that differences in the molecular pathology of otherwise indistinguishable cancers substantially impact the...

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Bibliographic Details
Published in:Nature reviews. Gastroenterology & hepatology Vol. 16; no. 4; pp. 207 - 220
Main Authors: Collisson, Eric A., Bailey, Peter, Chang, David K., Biankin, Andrew V.
Format: Journal Article
Language:English
Published: London Nature Publishing Group UK 01.04.2019
Nature Publishing Group
Subjects:
631/337/2019
692/4020/1503/1712/1713
692/4028/67/68
Biomarkers, Tumor - genetics
Biomarkers, Tumor - metabolism
Biomedicine
Cancer therapies
Carcinoma, Pancreatic Ductal - diagnosis
Carcinoma, Pancreatic Ductal - genetics
Carcinoma, Pancreatic Ductal - metabolism
Carcinoma, Pancreatic Ductal - therapy
Care and treatment
Clinical Decision-Making - methods
Decision making
Development and progression
Gastroenterology
Genetic aspects
Genetic Markers
Genotype
Health aspects
Hepatology
Humans
Medicine
Medicine & Public Health
Morbidity
Pancreatic cancer
Pancreatic Neoplasms - diagnosis
Pancreatic Neoplasms - genetics
Pancreatic Neoplasms - metabolism
Pancreatic Neoplasms - therapy
Patients
Prognosis
Review Article
Risk Assessment
Taxonomy
United States
ISSN:1759-5045, 1759-5053, 1759-5053
Online Access:Get full text
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Summary:Cancers that appear morphologically similar often have dramatically different clinical features, respond variably to therapy and have a range of outcomes. Compelling evidence now demonstrates that differences in the molecular pathology of otherwise indistinguishable cancers substantially impact the clinical characteristics of the disease. Molecular subtypes now guide preclinical and clinical therapeutic development and treatment in many cancer types. The ability to predict optimal therapeutic strategies ahead of treatment improves overall patient outcomes, minimizing treatment-related morbidity and cost. Although clinical decision making based on histopathological criteria underpinned by robust data is well established in many cancer types, subtypes of pancreatic cancer do not currently inform treatment decisions. However, accumulating molecular data are defining subgroups in pancreatic cancer with distinct biology and potential subtype-specific therapeutic vulnerabilities, providing the opportunity to define a de novo clinically applicable molecular taxonomy. This Review summarizes current knowledge concerning the molecular subtyping of pancreatic cancer and explores future strategies for using a molecular taxonomy to guide therapeutic development and ultimately routine therapy with the overall goal of improving outcomes for this disease. This Review summarizes current knowledge concerning the molecular subtyping of pancreatic cancer and explores future strategies using molecular taxonomy to guide therapeutic development and therapy with the overall goal of improving outcomes for this disease. Key points Pancreatic cancer is soon to become the second leading cause of cancer-related death. Histopathological criteria do not adequately inform treatment decisions for pancreatic cancer. A molecular taxonomy could improve outcomes with current treatments and accelerate therapeutic development through better patient selection. Emerging molecular taxonomies define biological differences between subtypes that are associated with prognosis. Genomic and transcriptomic subtypes potentially enrich for therapeutic vulnerabilities and require preclinical and clinical assessment.
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ISSN:1759-5045
1759-5053
1759-5053
DOI:10.1038/s41575-019-0109-y