Published online Aug 21, 2014. doi: 10.3748/wjg.v20.i31.10769
Revised: January 26, 2014
Accepted: April 8, 2014
Published online: August 21, 2014
Processing time: 297 Days and 22.1 Hours
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.
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.