Evidence for molecular subtyping in pancreatic ductal adenocarcinoma: a systematic review
Abstract
Background: Pancreatic Ductal Adenocarcinoma (PDAC) patients exhibit varied responses to multimodal therapy. RNA gene sequencing has unravelled distinct tumour biology subtypes, forming the focus of this review exploring its impact on survival outcomes.
Methods: A systematic search across PubMed, Medline, Embase, and CINAHL databases targeted studies assessing long-term overall and disease-free survival in PDAC patients with molecular subtyping.
Results: Fifteen studies including 2731 patients were identified. Molecular subtyping was performed by RNA sequencing and Immunohistochemistry in 14 studies and by Mass Spectrometry in 1 study. Two main tumour subtypes were identified (classical and basal-like or squamous) with basal like associated with poorer outcomes. Further subtypes were identified in individual studies. Superior survival was seen with classical subtype in all other analyses that compared the classical and basal subtypes. High risk stromal subtypes were identified on further analysis of the stroma and were associated with a worse survival independent of the tumour subtype.
Conclusion: Molecular subtyping of PDAC specimens can identify patients with high-risk tumour biology and poor survival outcomes. Routine subtyping is limited by the cost of RNA sequencing and the volume of raw data generated which has made its translation into routine clinical practice difficult.
Author
Citations
Altmetric:
Date
2024-02-10
Type
Article
Subject
pancreatic ductal adenocarcinoma, molecular subtyping
Collections
Citation
Robertson, F. P., Cameron, A., Spiers, H. V. M., Joseph, N., Taylor, E., Ratnayake, B., Jamieson, N. B., & Pandanaboyana, S. (2024). Evidence for molecular subtyping in pancreatic ductal adenocarcinoma: a systematic review. HPB : the official journal of the International Hepato Pancreato Biliary Association, S1365-182X(24)00020-0. Advance online publication. https://doi.org/10.1016/j.hpb.2024.02.001