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

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy with poor outcomes. Although the management strategies have evolved in recent years, the PDAC 5-year survival rate remains at only 9%; it may become the second leading cause of cancer death in the USA by 2030. Only 15–20% of PDAC patients are eligible to undergo surgery; diagnostic biopsies and individualized treatment present a more significant challenge for the remaining group. Endoscopic ultrasound-guided tissue acquisition (EUS-TA) has been widely used in the diagnosis of pancreatic masses. With the advancement of this sampling technique, adequate specimens can be obtained from all patients with PDAC in both early and late clinical stages. Recent data suggest that the specimens obtained from EUS-TA might be used to establish viable preclinical models, which conserve the genetic mutation and preserve the heterogeneity of the original tumors. Additionally, any drug sensitivity evident in the EUS-TA-derived preclinical models might predict the clinical response, thus guiding the prospective therapeutic selection. As we move toward the era of precision medicine, this review provides an update on the role of EUS-TA as a method for obtaining genetic material used in preclinical models that can assess and stratify individuals according to their individual cancer biology.

Effect of wet-heparinized suction on the quality of mediastinal solid tumor specimens obtained by endoscopic ultrasound-guided fine-needle aspiration: a retrospective study from a single center

“…For example, next-generation sequencing can be performed on endoscopic ultrasound-guided tissue acquisition specimens to guide clinical diagnosis. Next-generation sequencing also could be used to establish clinical models to guide treatment, and promote the development of precision medicine [ 32 ].…”

Detection value of endoscopic ultrasound-guided 19G fine-needle wet-heparinized suction for pancreatic solid tumors: a randomized controlled trial

“…The pathological diagnosis of the specimens has shifted from cytology to histology, and is now changing to genetics. Several studies perform Next Generation Sequencing (NGS) for endoscopic ultrasound-guided tissue acquisition (EUS-TA), use genetic analyses to guide the clinical diagnosis, and construct clinical models to guide the treatment ( 24 , 25 ). These make it possible to conduct the Precision Medicine.…”

Role of Endoscopic Ultrasound in Diagnosis of Pancreatic Ductal Adenocarcinoma

“…As PDAC is a phenotypically and genomically heterogeneous tumor, it is difficult to study the tumor behavior and treatment response ex vivo. EUS TA-derived samples have been used for developing pre-clinical models for human PDAC, which are as follows: patient-derived cells (PDCs), patient-derived tumor xenografts (PDTXs), and patient-derived organoids (PDOs) [ 142 ]. The results of PDTXs were not encouraging due to the lack of availability of a sufficient number of cells or tissue; additionally, they were more time-consuming and economically challenging.…”