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Precision Medicine for Pancreatic Cancer and Cholangiocarcinoma

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Management of Pancreatic Cancer and Cholangiocarcinoma

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Abstract

Next-generation sequencing techniques, commercially available since 2006, have enabled cost- and time-effective sequencing of tumor DNA. Olaparib, a poly(ADP-ribose) polymerase (PARP) inhibitor, used as maintenance therapy following platinum-based chemotherapy, has been shown to improve progression-free survival in patients with metastatic pancreatic cancer and a germline BRCA1/2 mutation. KRAS mutations are predominant in pancreatic cancer. Although effective targeted therapy remains to be established, KRAS G12C inhibitors and the combined inhibition of MEK and autophagy are candidates for future treatment strategies. Regarding KRAS wild-type, BRAF-activating alterations, microsatellite instability, and kinase fusion genes, especially NRG1 fusion genes, are important genetic abnormalities of high interest as treatment targets.

Biliary tract cancer is an umbrella term that encompasses carcinoma of the extrahepatic bile ducts, carcinoma of the gallbladder, ampullary carcinoma, and intrahepatic cholangiocarcinoma, all of which are characterized by wide genomic variation associated with the different primary organs affected. For example, in intrahepatic cholangiocarcinoma, FGFR2 rearrangement and IDH1 mutation are important actionable driver genes successfully targeted in clinical trials. BRAF, HER2/neu, BRCA1/2, and overexpression of c-MET genes are among the other candidate targets.

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Authors and Affiliations

  1. Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan

    Chigusa Morizane

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  1. Chigusa Morizane
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Correspondence to Chigusa Morizane .

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Editors and Affiliations

  1. Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan

    Hiroyuki Isayama

  2. Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Yousuke Nakai

  3. Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan

    Takashi Sasaki

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Morizane, C. (2021). Precision Medicine for Pancreatic Cancer and Cholangiocarcinoma. In: Isayama, H., Nakai, Y., Sasaki, T. (eds) Management of Pancreatic Cancer and Cholangiocarcinoma. Springer, Singapore. https://doi.org/10.1007/978-981-16-2870-2_14

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  • DOI: https://doi.org/10.1007/978-981-16-2870-2_14

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