Practice the Precision Medicine for Pancreatic Cancer
11:10-11:40, Room 104 (104講堂)
Abstract - Practice the Precision Medicine for Pancreatic Cancer
Chemotherapy has been a standard of care of nonresectable pancreatic cancer for decades. Although surgical resection is the only curative treatment for pancreatic cancer, surgery alone or surgery followed adjuvant chemotherapy cure a small percentage of the patients. Viewing from the clinical prospective, the majority of the pancreatic cancer patients would appear to be the same with poor prognosis. However, accumulated evidence from cancer genomics studies, every individual patient may have a different biologic identity. Although microsatellites instability may only occur in less than 1% of the metastatic pancreatic cancer patients, this small subgroup of pancreatic cancer patients responded to immune checkpoint inhibitor treatments. This has suggested that we should define the pancreatic cancer patients in a much higher “resolution” in order to capture these small subgroups of pancreatic cancer patients than the current cancer genomics studies have been attempted to. Therefore, it has become necessary to manage the patient cancer patients with a precision medicine approach. However, the current precision medicine approach for pancreatic cancer has not been successful due to lack of effective therapies and knowledge that can be utilized. More importantly, even if the patients have an actionable mutation in their tumors, there is no effective and efficient system to identify the patients in a timely fashion. Therefore, we have proposed to develop a new system for the precision medicine management of pancreatic cancer patients, including: 1) perform the next generation sequencing at the time of diagnosis and track the patients’ outcome prospectively; 2) develop and disseminate the knowledge and tools to enable increasingly precision definition of the patient subgroups through feeding back the outcome data and to adjust the management of other pancreatic cancer patients in the same subgroups.