Abstract
ABSTRACT Ductal pancreatic adenocarcinoma remains a disease with dismal prognosis and several treatment approaches resulted in disappointing results. A better knowledge of molecular pathways involved in its development are mandatory in order to improve therapeutic results. Infact, though a model for the development of pancreatic adenocarcinoma has been proposed some years ago, this is not able to explain the role of stroma as well as which pathways could be effectively druggable. Furthermore, the results of clinical trials with biological agents (tipifarnib, cetuximab, bevacizumab, axitinib, sorafenib) are really disappointing. Therefore, biological characterization of ductal pancreatic adenocarcinoma may help to identify new pathways in order to select the best treatment for each patient. We should consider ductal adenocarcinoma as an heterogeneous disease probably due to the different pathogenesis: chronic inflammatory disease, mucinous tumors, hereditary tumors, resulting in different specific genetic alterations. The knowledge of these alterations may allow the identification of subgroups as well as the definition of specific treatment approaches. An assessment of potentially relevant pathways and how to inhibit them will be presented. Disclosure The author has declared no conflicts of interest.
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