Liquid Biopsy Approach for Pancreatic Ductal Adenocarcinoma.
Etienne BuscailCharlotte MaulatFabrice MuscariLaurence ChichePierre CordelierSandrine DabernatCatherine Alix-PanabièresLouis BuscailPublished in: Cancers (2019)
Pancreatic cancer is a public health problem because of its increasing incidence, the absence of early diagnostic tools, and its aggressiveness. Despite recent progress in chemotherapy, the 5-year survival rate remains below 5%. Liquid biopsies are of particular interest from a clinical point of view because they are non-invasive biomarkers released by primary tumours and metastases, remotely reflecting disease burden. Pilot studies have been conducted in pancreatic cancer patients evaluating the detection of circulating tumour cells, cell-free circulating tumour DNA, exosomes, and tumour-educated platelets. There is heterogeneity between the methods used to isolate circulating tumour elements as well as the targets used for their identification. Performances for the diagnosis of pancreatic cancer vary depending of the technique but also the stage of the disease: 30-50% of resectable tumours are positive and 50-100% are positive in locally advanced and/or metastatic cases. A significant prognostic value is demonstrated in 50-70% of clinical studies, irrespective of the type of liquid biopsy. Large prospective studies of homogeneous cohorts of patients are lacking. One way to improve diagnostic and prognostic performances would be to use a combined technological approach for the detection of circulating tumour cells, exosomes, and DNA.
Keyphrases
- cell free
- locally advanced
- public health
- induced apoptosis
- circulating tumor
- squamous cell carcinoma
- cell cycle arrest
- stem cells
- end stage renal disease
- mesenchymal stem cells
- ionic liquid
- ultrasound guided
- rectal cancer
- risk factors
- small cell lung cancer
- newly diagnosed
- neoadjuvant chemotherapy
- chronic kidney disease
- ejection fraction
- loop mediated isothermal amplification
- real time pcr
- endoplasmic reticulum stress
- study protocol
- signaling pathway
- phase ii study
- open label
- case control
- bone marrow
- liver metastases
- circulating tumor cells
- pi k akt