Patterns of Recurrence After Surgery for Pancreatic Cancer

Groot, Vincent P.; Daamen, Lois A; He, Jin; Wolfgang, Christopher L.; Molenaar, I.

doi:10.1007/978-3-030-53786-9_74

Cited by 2 publications

(1 citation statement)

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“…Unfortunately, imaging provides limited information and can lead to misdiagnosis of 20% of unresectable PDAs and 36% of locally advanced or metastatic tumors as R-PDAs [ 93 , 94 ]. In resected tumors, the recurrence rate is very high (69–90%), and long-term survival (>10 years) is merely 4% (outcomes of key AT studies are summarized in Supplementary Table S3 ) [ 5 , 95 , 96 , 97 , 98 , 99 , 100 ]. Addition of NAT (chemotherapy alone with/without radiation) has not been found to be significantly associated with differences in the resection rate and survival in R-PDA, BR-PDA, and LA-PDA [ 101 ].…”

Section: Cfdna For Pormentioning

confidence: 99%

Is Cell-Free DNA Testing in Pancreatic Ductal Adenocarcinoma Ready for Prime Time?

Sheel

Addison

Nuguru

et al. 2022

Cancers

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Cell-free DNA (cfDNA) testing currently does not have a significant role in PDA management: it is insufficient to diagnose PDA, and its use is primarily restricted to identifying targetable mutations (if tissue is insufficient or unavailable). cfDNA testing has the potential to address critical needs in PDA management, such as pre-operative risk stratification (POR), prognostication, and predicting (and monitoring) treatment response. Prior studies have focused primarily on somatic mutations, specifically KRAS variants, and have shown limited success in addressing prognosis and POR. Recent studies have demonstrated the importance of other less prevalent mutations (ERBB2 and TP53), but no studies have provided reliable mutation panels for clinical use. Methylation aberrations in cfDNA (epigenetic markers) in PDA have been relatively less explored. However, early evidence has suggested they offer diagnostic and, to some extent, prognostic value. The inclusion of epigenetic markers of cfDNA adds another dimension to genomic testing and may open new therapeutic avenues beyond addressing critical areas of need in PDA treatment. For cfDNA to substantially influence PDA management, concerted efforts are required to include less frequent mutations and epigenetic markers. Furthermore, relying on KRAS mutations for PDA management will always be inadequate.

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