Signal-Targeted Therapies and Resistance Mechanisms in Pancreatic Cancer: Future Developments Reside in Proteomics

For patients with metastatic pancreatic cancer that are not eligible for surgery, signal-targeted therapies have so far failed to significantly improve survival. These therapeutic options have been tested in phase II/III clinical trials mostly in combination with the reference treatment gemcitabine....

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Main Authors: Célia Cintas, Thibaut Douché, Nicole Therville, Silvia Arcucci, Fernanda Ramos-Delgado, Céline Basset, Benoît Thibault, Julie Guillermet-Guibert
Format: Article
Language:English
Published: MDPI AG 2018-06-01
Series:Cancers
Subjects:
Online Access:http://www.mdpi.com/2072-6694/10/6/174
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author Célia Cintas
Thibaut Douché
Nicole Therville
Silvia Arcucci
Fernanda Ramos-Delgado
Céline Basset
Benoît Thibault
Julie Guillermet-Guibert
author_facet Célia Cintas
Thibaut Douché
Nicole Therville
Silvia Arcucci
Fernanda Ramos-Delgado
Céline Basset
Benoît Thibault
Julie Guillermet-Guibert
author_sort Célia Cintas
collection DOAJ
description For patients with metastatic pancreatic cancer that are not eligible for surgery, signal-targeted therapies have so far failed to significantly improve survival. These therapeutic options have been tested in phase II/III clinical trials mostly in combination with the reference treatment gemcitabine. Innovative therapies aim to annihilate oncogenic dependency, or to normalize the tumoural stroma to allow immune cells to function and/or re-vascularisation to occur. Large scale transcriptomic and genomic analysis revealed that pancreatic cancers display great heterogeneity but failed to clearly delineate specific oncogene dependency, besides oncogenic Kras. Beyond these approaches, proteomics appears to be an appropriate approach to classify signal dependency and to identify specific alterations at the targetable level. However, due to difficulties in sampling, proteomic data for this pathology are scarce. In this review, we will discuss the current state of clinical trials for targeted therapies against pancreatic cancer. We will then highlight the most recent proteomic data for pancreatic tumours and their metastasis, which could help to identify major oncogenic signalling dependencies, as well as provide future leads to explain why pancreatic tumours are intrinsically resistant to signal-targeted therapies. We will finally discuss how studies on phosphatidylinositol-3-kinase (PI3K) signalling, as the paradigmatic pro-tumoural signal downstream of oncogenic Kras in pancreatic cancer, would benefit from exploratory proteomics to increase the efficiency of targeted therapies.
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spelling doaj.art-2e46419e3ce244989e023c36c4d445502023-08-02T01:15:06ZengMDPI AGCancers2072-66942018-06-0110617410.3390/cancers10060174cancers10060174Signal-Targeted Therapies and Resistance Mechanisms in Pancreatic Cancer: Future Developments Reside in ProteomicsCélia Cintas0Thibaut Douché1Nicole Therville2Silvia Arcucci3Fernanda Ramos-Delgado4Céline Basset5Benoît Thibault6Julie Guillermet-Guibert7INSERM U1037, CRCT, Université Paul Sabatier, 31037 Toulouse, FranceINSERM U1037, CRCT, Université Paul Sabatier, 31037 Toulouse, FranceINSERM U1037, CRCT, Université Paul Sabatier, 31037 Toulouse, FranceINSERM U1037, CRCT, Université Paul Sabatier, 31037 Toulouse, FranceINSERM U1037, CRCT, Université Paul Sabatier, 31037 Toulouse, FranceINSERM U1037, CRCT, Université Paul Sabatier, 31037 Toulouse, FranceINSERM U1037, CRCT, Université Paul Sabatier, 31037 Toulouse, FranceINSERM U1037, CRCT, Université Paul Sabatier, 31037 Toulouse, FranceFor patients with metastatic pancreatic cancer that are not eligible for surgery, signal-targeted therapies have so far failed to significantly improve survival. These therapeutic options have been tested in phase II/III clinical trials mostly in combination with the reference treatment gemcitabine. Innovative therapies aim to annihilate oncogenic dependency, or to normalize the tumoural stroma to allow immune cells to function and/or re-vascularisation to occur. Large scale transcriptomic and genomic analysis revealed that pancreatic cancers display great heterogeneity but failed to clearly delineate specific oncogene dependency, besides oncogenic Kras. Beyond these approaches, proteomics appears to be an appropriate approach to classify signal dependency and to identify specific alterations at the targetable level. However, due to difficulties in sampling, proteomic data for this pathology are scarce. In this review, we will discuss the current state of clinical trials for targeted therapies against pancreatic cancer. We will then highlight the most recent proteomic data for pancreatic tumours and their metastasis, which could help to identify major oncogenic signalling dependencies, as well as provide future leads to explain why pancreatic tumours are intrinsically resistant to signal-targeted therapies. We will finally discuss how studies on phosphatidylinositol-3-kinase (PI3K) signalling, as the paradigmatic pro-tumoural signal downstream of oncogenic Kras in pancreatic cancer, would benefit from exploratory proteomics to increase the efficiency of targeted therapies.http://www.mdpi.com/2072-6694/10/6/174pancreatic cancerproteomicsPI3K pathwayprecision medicinepredictor of therapeutic responseintegrated biologyproteo-genomics
spellingShingle Célia Cintas
Thibaut Douché
Nicole Therville
Silvia Arcucci
Fernanda Ramos-Delgado
Céline Basset
Benoît Thibault
Julie Guillermet-Guibert
Signal-Targeted Therapies and Resistance Mechanisms in Pancreatic Cancer: Future Developments Reside in Proteomics
Cancers
pancreatic cancer
proteomics
PI3K pathway
precision medicine
predictor of therapeutic response
integrated biology
proteo-genomics
title Signal-Targeted Therapies and Resistance Mechanisms in Pancreatic Cancer: Future Developments Reside in Proteomics
title_full Signal-Targeted Therapies and Resistance Mechanisms in Pancreatic Cancer: Future Developments Reside in Proteomics
title_fullStr Signal-Targeted Therapies and Resistance Mechanisms in Pancreatic Cancer: Future Developments Reside in Proteomics
title_full_unstemmed Signal-Targeted Therapies and Resistance Mechanisms in Pancreatic Cancer: Future Developments Reside in Proteomics
title_short Signal-Targeted Therapies and Resistance Mechanisms in Pancreatic Cancer: Future Developments Reside in Proteomics
title_sort signal targeted therapies and resistance mechanisms in pancreatic cancer future developments reside in proteomics
topic pancreatic cancer
proteomics
PI3K pathway
precision medicine
predictor of therapeutic response
integrated biology
proteo-genomics
url http://www.mdpi.com/2072-6694/10/6/174
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