Despite improvements in surgical techniques and adjuvant chemotherapy, the overall mortality rates in pan- creatic cancer have generally remained relatively un-changed and the 5-year survival rate is actually below 2%...Despite improvements in surgical techniques and adjuvant chemotherapy, the overall mortality rates in pan- creatic cancer have generally remained relatively un-changed and the 5-year survival rate is actually below 2%. This paper will address the importance of achieving an early diagnosis and identifying markers for prog- nosis and response to therapy such as genes, proteins, microP, NAs or epigenetic modifications. However, there are still major hurdles when translating investigational biomarkers into routine clinical practice. Furthermore, novel ways of secondary screening in high-risk individu- als, such as artificial neural networks and modern imaging, will be discussed. Drug resistance is ubiquitous in pancreatic cancer. Several mechanisms of drug resistance have already been revealed, including human equilibrative nucleoside transporter-1 status, multidrug resistance proteins, aberrant signaling pathways, mi-croRNAs, stromal influence, epithelial-mesenchymal transition-type cells and recently the presence of can- cer stem cells/cancer-initiating cells. These factors must be considered when developing more customized types of intervention （＇personalized medicine＇S. In the future, multifunctional nanoparticles that combine a specific targeting agent, an imaging probe, a cell-penetrating agent, a biocompatible polymer and an anti-cancer drug may become valuable for the management of pa- tients with pancreatic cancer.展开更多
文摘Despite improvements in surgical techniques and adjuvant chemotherapy, the overall mortality rates in pan- creatic cancer have generally remained relatively un-changed and the 5-year survival rate is actually below 2%. This paper will address the importance of achieving an early diagnosis and identifying markers for prog- nosis and response to therapy such as genes, proteins, microP, NAs or epigenetic modifications. However, there are still major hurdles when translating investigational biomarkers into routine clinical practice. Furthermore, novel ways of secondary screening in high-risk individu- als, such as artificial neural networks and modern imaging, will be discussed. Drug resistance is ubiquitous in pancreatic cancer. Several mechanisms of drug resistance have already been revealed, including human equilibrative nucleoside transporter-1 status, multidrug resistance proteins, aberrant signaling pathways, mi-croRNAs, stromal influence, epithelial-mesenchymal transition-type cells and recently the presence of can- cer stem cells/cancer-initiating cells. These factors must be considered when developing more customized types of intervention （＇personalized medicine＇S. In the future, multifunctional nanoparticles that combine a specific targeting agent, an imaging probe, a cell-penetrating agent, a biocompatible polymer and an anti-cancer drug may become valuable for the management of pa- tients with pancreatic cancer.
