title: Toward stratification of patients with pancreatic cancer: Past lessons from traditional approaches and future applications with physical biomarkers.
abstract: Pancreatic ductal adenocarcinoma (PDAC) has a high mortality rate and outcomes have not improved substantially for decades. Significant attention has focused on the biological drivers of the disease, and preclinical work has pointed to multiple biomarker candidates and therapeutic avenues. However, translation of these promising biomarkers and treatment strategies to patients has not been overwhelmingly successful. New strategies to account for the significant heterogeneity of the disease are needed so that rational treatments can be administered. Here, we focus on how physical sciences-based approaches may play a role in stratifying patients for clinical trials, and how this view of PDAC may reinvigorate treatment strategies that have been abandoned after "failing" to fulfill their potential in unselected patient populations. By complementing biological approaches, the development of physical biomarkers of PDAC may help deliver on the promise of personalized medicine for this devastating disease.
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Eugene J
authors.initials: EJ
authors.lastname: Koay
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Amer
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Flavio E
authors.initials: FE
authors.lastname: Baio
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Alexander O
authors.initials: AO
authors.lastname: Ondari
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: jbflemin@mdanderson.org.
authors.forename: Jason B
authors.initials: JB
authors.lastname: Fleming
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism*; D021441:Carcinoma, Pancreatic Ductal / Q000188:drug therapy / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D019008:Drug Resistance, Neoplasm; D004734:Energy Metabolism; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D058990:Molecular Targeted Therapy; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D017154:Stromal Cells / Q000378:metabolism / Q000473:pathology; D016896:Treatment Outcome; D019139:Tumor Escape; D059016:Tumor Microenvironment
chemical_list: D020533:Angiogenesis Inhibitors; D014408:Biomarkers, Tumor
keywords: Drug resistance; Mass transport; Oncophysics; Pancreatic cancer; Tumor microenvironment