title: Pancreatic cancer actionable genes in precision medicine and personalized surgery.
abstract: Pancreatic ductal adenocarcinoma (PDAC) is a deadly cancer with an overall 5-year survival rate less than 5% due to the poor early diagnosis and lack of effective therapeutic options. The most effective therapy remains surgery, however post-operative survival could be enhanced with effective adjuvant therapy. The massive information gained from Omics techniques on PDAC at the beginning of the 21st century is a remarkable accomplishment. However, the information gained from the omics data, including next generation sequencing data, has yet to successfully affect care of patients suffering with PDAC. Therefore, we propose the development of an actionable genomic platform that matches a patient's PDAC clinically actionable genes with potential targeted adjuvant therapies. Using this platform, PDX1 has been identified as a potential actionable gene for PDAC, therefore, RNAi therapy, gene therapy and small inhibitory drugs, all targeting PDX1, serve as potential targeted adjuvant therapies. Preclinical studies support the hypothesis that identification of PDAC actionable genes could permit translation of a patient's genomic information into precision targeted adjuvant therapy for PDAC.
authors.affiliation: Division of General Surgery, Department of Surgery, David Geffen School of Medicine at University of California Los Angeles, CA, USA.
authors.forename: Juehua
authors.initials: J
authors.lastname: Yu
authors.affiliation: Division of General Surgery, Department of Surgery, David Geffen School of Medicine at University of California Los Angeles, CA, USA.
authors.forename: Shi-He
authors.initials: SH
authors.lastname: Liu
authors.affiliation: Division of General Surgery, Department of Surgery, David Geffen School of Medicine at University of California Los Angeles, CA, USA.
authors.forename: Robbi
authors.initials: R
authors.lastname: Sanchez
authors.affiliation: Mary Crowley Cancer Research Center, Dallas, TX, USA.
authors.forename: John
authors.initials: J
authors.lastname: Nemunaitis
authors.affiliation: Department of Medicine, David Geffen School of Medicine at University of California Los Angeles, CA, USA.
authors.forename: Enrique
authors.initials: E
authors.lastname: Rozengurt
authors.affiliation: Division of General Surgery, Department of Surgery, David Geffen School of Medicine at University of California Los Angeles, CA, USA. Electronic address: cbrunicardi@mednet.ucla.edu.
authors.forename: F Charles
authors.initials: FC
authors.lastname: Brunicardi
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics* / Q000628:therapy*; D006801:Humans; D010190:Pancreatic Neoplasms / Q000235:genetics* / Q000628:therapy*; D057285:Precision Medicine
keywords: Actionable genes; Molecular surgery; Pancreatic cancer