Endoscopic Ultrasound-Guided Sampling for Personalized Pancreatic Cancer Treatment

Abstract

Pancreatic cancer is the most lethal solid malignancy, and the number of patients with pancreatic cancer is increasing. Systemic chemotherapies are often ineffective for such patients, and there is an urgent need for personalized medicine. Unlike other types of cancer, personalized treatments for pancreatic cancer are still in development. Consequently, pancreatic cancer is less sensitive to anticancer drugs and is often refractory to common treatments. Therefore, advances in personalized medicine for pancreatic cancer are necessary. This review examined advances in personalized medicine for pancreatic cancer, including the use of endoscopic ultrasound (EUS)-guided sampling. EUS-guided sampling is widely used for diagnosing pancreatic tumors and is expected to be applied to sampled tissues. Additionally, there has been an increase in clinical research using EUS-guided sampling. The combination of precision medicine using genomic testing and pharmacological profiles based on high-throughput drug sensitivity testing using patient-derived organoids is expected to revolutionize pancreatic cancer treatment.

Preclinical models derived from endoscopic ultrasound-guided tissue acquisition for individualized treatment of pancreatic ductal adenocarcinoma

“…These findings reflect the complexity of the stroma and its influence on epithelial tumorigenesis ( 91 ). Finally, in principle, TA-PDOs are suitable for high throughput screening, but the technical constraints and extensive manipulation have hampered progress toward simple clinical applications ( 38 ). Further development is needed to make it more adaptable to high-throughput screening.…”

“…In general, precision medicine for cancer includes two key aspects: Genetic profiling and drug target validation through patient-derived models ( 37 ). The former aspect has been studied and reviewed in depth ( 27 , 38 , 39 ). Here we review the advances in establishing and applying different patient-derived preclinical models of PDAC isolated from EUS-TA specimens for drug target validation.…”

Experimental and translational research in gastrointestinal endoscopy, the Japan Gastroenterological Endoscopy Society and perspective

“…Thus, sufficient EUS-guided sampling has the potential to advance precision medicine by allowing the assessment of genomic alterations. 15 The organoid culture system has made it possible to expand normal and cancer adult cells using endoscopic biopsy samples taken from colonic mucosa of patients with inflammatory bowel disease, recently expanding to usage of the EUS-assisted samples. [15][16][17] Furthermore, high-throughput methods to examine drug sensitivity in organoids have been developed.…”

“…However, EUS‐guided samples are often unusable due to a paucity of cancer compartments, it is necessary to identify a method of collecting samples for the genomic testing. Thus, sufficient EUS‐guided sampling has the potential to advance precision medicine by allowing the assessment of genomic alterations 15 . The organoid culture system has made it possible to expand normal and cancer adult cells using endoscopic biopsy samples taken from colonic mucosa of patients with inflammatory bowel disease, recently expanding to usage of the EUS‐assisted samples 15–17 .…”

“…15 The organoid culture system has made it possible to expand normal and cancer adult cells using endoscopic biopsy samples taken from colonic mucosa of patients with inflammatory bowel disease, recently expanding to usage of the EUS-assisted samples. [15][16][17] Furthermore, high-throughput methods to examine drug sensitivity in organoids have been developed. If an effective drug can be identified more quickly, it may be possible to select the appropriate treatment for intractable GI malignancies.…”