Molecular classification as prognostic factor and guide for treatment decision of pancreatic cancer

被引:28
作者
Birnbaum, David J. [1 ,2 ,3 ]
Bertucci, Francois [1 ,2 ,4 ]
Finetti, Pascal [1 ,2 ]
Birnbaum, Daniel [1 ,2 ]
Mamessier, Emilie [1 ,2 ]
机构
[1] Aix Marseille Univ, CNRS, Dept Oncol Mol, Ctr Rech Cancerol Marseille,INSERM,UMR1068,UMR725, Marseille, France
[2] Aix Marseille Univ, Fac Med, Marseille, France
[3] AP HM, Dept Chirurg Gen & Viscerale, Marseille, France
[4] Inst Paoli Calmettes, Dept Oncol Med, 232 Bd Ste Marguerite, F-13009 Marseille, France
来源
BIOCHIMICA ET BIOPHYSICA ACTA-REVIEWS ON CANCER | 2018年 / 1869卷 / 02期
关键词
Pancreatic cancer; Expression profiling; Genomic alteration; Prognosis; Survival; Personalized medicine; DUCTAL ADENOCARCINOMA; TUMOR-STROMA; KAPPA-B; EXPRESSION; SUBTYPES; SURVIVAL; GEMCITABINE; RESISTANCE; ANTIBODY; GENE;
D O I
10.1016/j.bbcan.2018.02.001
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
Clinico-pathological factors fail to consistently predict the outcome after pancreatic resection for pancreatic ductal adenocarcinoma (PDAC). PDACs show a high level of inter- and intra- tumor genetic heterogeneity. A molecular classification should help sort patients into less heterogeneous and more appropriate groups regarding the metastatic risk and the therapeutic response, with the consequences of better predicting evolution and better orienting the treatment. PDAC can be classified based on mutational subtypes and 18gene alterations. Whole-genome sequencing identified mutational signatures, mutational burden and hyper-mutated tumors with specific DNA repair defects. Their overlap/similarities allow the definition of molecular subtypes. DNA and RNA classifications can be used in prognosis assessment. They are useful in therapeutic choice for they allow the design of approaches that can predict the respective drug sensitivity of each molecular subtype. This review provides a comprehensive analysis of available molecular classifications in PDAC and how this can help guide clinical decisions.
引用
收藏
页码:248 / 255
页数:8
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