Abstract
Precision medicine in cancer treatment refers to targeted therapy based on the evaluation of biomarkers. Although precision medicine for pancreatic cancer (PC) remains challenging, novel biomarker-based therapies, such as pembrolizumab, olaparib, and entrectinib, have been emerging. Most commonly, endoscopic ultrasound-guided tissue acquisition (EUS-TA) had been used for the diagnosis of PC until now. However, advances in EUS-TA devices and biomarker testing, especially next-generation sequencing, have opened up the possibility of sequencing of various genes even in limited amounts of tissue samples obtained by EUS-TA, and identifying potential genetic alterations as therapeutic targets. Precision medicine benefits only a small population of patients with PC, but biomarker-based therapy has shown promising results in patients who once had no treatment options. Now, the role of EUS-TA has extended beyond diagnosis into decision-making regarding the treatment of PC. In this review, we mainly discuss tissue sampling by EUS-TA for biomarker testing and the current status of precision medicine for PC.
Highlights
Accepted: 22 June 2021Pancreatic cancer (PC) is one of the deadliest cancers known and the fourth leading cause of cancer death
We summarize the recent advances in the application of endoscopic ultrasound-guided tissue acquisition (EUS-TA) to biomarker testing and the current status of precision medicine for pancreatic cancer (PC) based on these biomarkers
A recent prospective study showed that the sensitivity of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for the diagnosis of a solid pancreatic mass is over 90% [33,34]
Summary
Pancreatic cancer (PC) is one of the deadliest cancers known and the fourth leading cause of cancer death. In a meta-analysis conducted to compare the diagnostic efficacy of multiple imaging tests for the diagnosis of PC, CT showed a high pooled sensitivity and specificity of about 90% [11]. A recent prospective study showed that the sensitivity of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for the diagnosis of a solid pancreatic mass is over 90% [33,34]. In addition to such conventional pathological assessment, the importance of ancillary studies, such as immunohistochemistry (IHC) and molecular analyses, has been emphasized for a long time.
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