Abstract
With dismal survival rate pancreatic cancer remains one of the most aggressive and devastating malignancy. Predominantly, due to the absence of a dependable methodology for early identification and limited therapeutic options for advanced disease. However, it takes over 17 years to develop pancreatic cancer from initiation of mutation to metastatic cancer; therefore, if diagnosed early; it may increase overall survival dramatically, thus, providing a window of opportunity for early detection. Recently, genomic expression analysis defined 4 subtypes of pancreatic cancer based on mutated genes. Hence, we need simple and standard, minimally invasive test that can monitor those altered genes or their associated pathways in time for the success of precision medicine, and liquid biopsy seems to be one answer to all these questions. Again, liquid biopsy has an ability to pair with genomic tests. Additionally, liquid biopsy based development of circulating tumor cells derived xenografts, 3D organoids system, real-time monitoring of genetic mutations by circulating tumor DNA and exosome as the targeted drug delivery vehicle holds lots of potential for the treatment and cure of pancreatic cancer. At present, diagnosis of pancreatic cancer is frantically done on the premise of CA19-9 and radiological features only, which doesn't give a picture of genetic mutations and epigenetic alteration involved. In this manner, the current diagnostic paradigm for pancreatic cancer diagnosis experiences low diagnostic accuracy. This review article discusses the current state of liquid biopsy in pancreatic cancer as diagnostic and therapeutic tools and future perspectives of research in the light of circulating tumor cells, circulating tumor DNA and exosomes.
Highlights
Pancreatic cancer (PC) remains one of the most deadly malignancies with an overall five-year survival probability less than 7% in all stages combined [1]
This review article discusses the current state of liquid biopsy in pancreatic cancer as diagnostic and therapeutic tools and future perspectives of research in the light of circulating tumor cells, circulating tumor DNA and exosomes
Direct inoculation of circulating tumor cells (CTCs) into immunecompromised mice has met with appreciable success in lung cancer and showed to mirror the response of chemotherapy in CTCd erived xenog rafts (CDXs) model to that of donor patient
Summary
Pancreatic cancer (PC) remains one of the most deadly malignancies with an overall five-year survival probability less than 7% in all stages combined [1]. Some researchers found it to be demanding and reported that CTCd erived xenog rafts (CDXs) foresee therapeutic response conflictingly in many cancers, including the PC [195, 201,202,203,204] This has been confirmed by recent research that pluripotent stem cells cultured in the lab acquire new mutations all the time, especially in TP53 gene [205], and this might be a suggesting reason that why CDXs doesn’t correspond to genetic mutations to that of the primary tumor, suggesting that research must be careful while genetic characterization of CDXs. By contrast, direct inoculation of CTCs into immunecompromised mice has met with appreciable success in lung cancer and showed to mirror the response of chemotherapy in CDXs model to that of donor patient. Methylation of ctDNA has been found to conceal tissue and cell specific information that may be invaluable in cancer patients to find tissuewww.oncotarget.com
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