Pancreatic cancer:Translational research aspects and clinical implications
Author(s): Daniel Ansari, Bi-Cheng Chen, Lei Dong, Meng-Tao Zhou, Roland Andersson, Department of Surgery, Clinical Sciences Lund, Skne University Hospital and Lund University, SE-221 85 Lund, Sweden, Zhejiang Provincial Top Key Discipline in Surgery, Wenzhou Key Laboratory of Surgery, Department of Surgery, First Affiliated Hospital, Wenzhou Medical College, Wenzhou 325000, Zhejiang Province, China, Department of Pathology, First Affiliated Hospital, Wenzhou Medical College, Wenzhou 325000, Zhejiang Province, China
Pages: 1417-1424
Year: 2012 Issue: 13
Journal: World Journal of Gastroenterology
Keyword: Pancreatic cancer; Biomarkers; Imaging; Artificial neural networks; Nanomedicine; Personalized medicine;
Abstract: Despite improvements in surgical techniques and adjuvant chemotherapy,the overall mortality rates in pancreatic cancer have generally remained relatively unchanged and the 5-year survival rate is actually below 2%.This paper will address the importance of achieving an early diagnosis and identifying markers for prognosis and response to therapy such as genes,proteins,microRNAs or epigenetic modifications.However,there are still major hurdles when translating investigational biomarkers into routine clinical practice.Furthermore,novel ways of secondary screening in high-risk individuals,such as artificial neural networks and modern imaging,will be discussed.Drug resistance is ubiquitous in pancreatic cancer.Several mechanisms of drug resistance have already been revealed,including human equilibrative nucleoside transporter-1 status,multidrug resistance proteins,aberrant signaling pathways,microRNAs,stromal influence,epithelial-mesenchymal transition-type cells and recently the presence of cancer stem cells/cancer-initiating cells.These factors must be considered when developing more customized types of intervention("personalized medicine").In the future,multifunctional nanoparticles that combine a specific targeting agent,an imaging probe,a cell-penetrating agent,a biocompatible polymer and an anticancer drug may become valuable for the management of patients with pancreatic cancer.
Pages: 1417-1424
Year: 2012 Issue: 13
Journal: World Journal of Gastroenterology
Keyword: Pancreatic cancer; Biomarkers; Imaging; Artificial neural networks; Nanomedicine; Personalized medicine;
Abstract: Despite improvements in surgical techniques and adjuvant chemotherapy,the overall mortality rates in pancreatic cancer have generally remained relatively unchanged and the 5-year survival rate is actually below 2%.This paper will address the importance of achieving an early diagnosis and identifying markers for prognosis and response to therapy such as genes,proteins,microRNAs or epigenetic modifications.However,there are still major hurdles when translating investigational biomarkers into routine clinical practice.Furthermore,novel ways of secondary screening in high-risk individuals,such as artificial neural networks and modern imaging,will be discussed.Drug resistance is ubiquitous in pancreatic cancer.Several mechanisms of drug resistance have already been revealed,including human equilibrative nucleoside transporter-1 status,multidrug resistance proteins,aberrant signaling pathways,microRNAs,stromal influence,epithelial-mesenchymal transition-type cells and recently the presence of cancer stem cells/cancer-initiating cells.These factors must be considered when developing more customized types of intervention("personalized medicine").In the future,multifunctional nanoparticles that combine a specific targeting agent,an imaging probe,a cell-penetrating agent,a biocompatible polymer and an anticancer drug may become valuable for the management of patients with pancreatic cancer.
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