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Pancreatic Cancer pp 1523-1549 | Cite as

Multiparameter Modalities for the Study of Patients in the Setting of Individualized Medicine

  • Koji Miyabayashi
  • David A. Tuveson
  • Kenneth H. Yu
Reference work entry

Abstract

The recent revolution in cancer genetics offers the promise of using genetic information to individualize patient treatment. In pancreatic cancer, numerous studies have described a genetic landscape characterized by a set of commonly mutated genes aggregated into core molecular pathways accompanied by numerous but infrequently mutated genes. Studies have also demonstrated significant intratumoral heterogeneity. Resistance against chemotherapeutic agents has also been attributed to difficulty of drug delivery through a rich stromal microenvironment. For these reasons, therapeutic development against pancreatic cancer has been challenging, and a number of promising agents have failed clinical trial testing. Personalized models have been studied as a tool for testing candidate drugs to select the most efficacious treatment. The patient-derived xenograft (PDX) is a well-established preclinical tool to improve the drug screening and development. The PDX model requires adequate tissue for transplantation, and failure is common. A recently described, innovative three-dimensional organoid culture platform can be exploited for genomic and functional studies at the level of the individual patient for personalized treatment approach. Organoid technology may fill the gap between cancer genetics and patient trials and allow personalized therapy design. Combination of genome-based medicine and individualized model-based drug screening may fulfill the promise of precision medicine for pancreatic cancer.

Keywords

Precision medicine Three-dimensional organoid culture Patient-derived xenograft (PDX) Genomic-based medicine 

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Koji Miyabayashi
    • 1
  • David A. Tuveson
    • 1
  • Kenneth H. Yu
    • 1
    • 2
  1. 1.Cold Spring Harbor LaboratoryCold Spring HarborUSA
  2. 2.Gastrointestinal Oncology ServiceMemorial Sloan Kettering Cancer Center and Weill Cornell Medical CollegeNew YorkUSA

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