Froeling Fieke E M, Casolino Raffaella, Pea Antonio, Biankin Andrew V, Chang David K
Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Garscube Estate, Switchback Road, Bearsden, Glasgow G61 1BD, UK.
Edinburgh Cancer Centre, Western General Hospital, NHS Lothian, Crewe Road South, Edinburgh EH4 2XU, UK.
J Clin Med. 2021 Jan 4;10(1):149. doi: 10.3390/jcm10010149.
Substantial progress in recent years has dramatically increased our knowledge of the molecular basis of cancer, revealing new potential therapeutic targets and paving the way for effective personalised medicine for the treatment of many tumour types. However, pancreatic cancer has been lagging behind in this success and continues to be one of the most lethal solid malignancies. Its molecular heterogeneity and the unselected design of the majority of clinical trials to date can in part explain the reason for our failure to make a significant change in the survival outcomes for patients with pancreatic cancer. A changing paradigm in drug development is required to validate the new molecular taxonomy and to rapidly translate preclinical discovery into clinical trials. Here, we review the molecular subtyping of pancreatic cancer, the challenges in identifying effective treatment regimens according to defined low-prevalence molecular subgroups and we illustrate a new model of translational therapeutic development that was established in the U.K. (Precision-Panc) as a potentially effective solution to improve outcomes for patients with pancreatic cancer.
近年来取得的重大进展极大地增加了我们对癌症分子基础的认识，揭示了新的潜在治疗靶点，并为治疗多种肿瘤类型的有效个性化医疗铺平了道路。然而，胰腺癌在这方面一直滞后，仍然是最致命的实体恶性肿瘤之一。其分子异质性以及迄今为止大多数临床试验未经过筛选的设计，在一定程度上可以解释我们未能显著改变胰腺癌患者生存结局的原因。需要一种不断变化的药物开发模式来验证新的分子分类法，并迅速将临床前发现转化为临床试验。在此，我们回顾了胰腺癌的分子亚型、根据定义的低流行分子亚组确定有效治疗方案所面临的挑战，并阐述了在英国建立的一种新的转化治疗开发模式（精准胰腺癌），作为改善胰腺癌患者结局的一种潜在有效解决方案。
