Reshaping preoperative treatment of pancreatic cancer in the era of precision medicine
Raffaella Casolino, Chiara Braconi, Giuseppe Malleo, Salvatore Paiella, Claudio Bassi, Michèle Milella, Stephan B. Dreyer, Fieke E. M. Froeling, David K. Chang, Andrew V. Biankin, Talia Golan
Abstract
This review summarises the recent evidence on preoperative therapeutic strategies in pancreatic cancer and discusses the rationale for an imminent need for a personalised therapeutic approach in non-metastatic disease. The molecular diversity of pancreatic cancer and its influence on prognosis and treatment response, combined with the failure of 'all-comer' treatments to significantly impact on patient outcomes, requires a paradigm shift towards a genomic-driven approach. This is particularly important in the preoperative, potentially curable setting, where a personalised treatment allocation has the substantial potential to reduce pancreatic cancer mortality.