Can we move towards personalised pancreatic cancer therapy?

Pancreatic ductal adenocarcinoma remains an unyielding adversary, with a 5-year survival of 5%, a figure unchanged in 50 years. Characterised by marked genetic heterogeneity, recent genomic sequencing efforts demonstrate that with the exclusion of a few known mutations, most mutations occur at a prevalence of <5%. Current systemic chemotherapeutics, when used in an all-comer approach, are at best modestly effective, yet are associated with responses in small groups of undefined patients. Defining these subgroups and targeting them with the appropriate therapy in a personalized or stratified approach holds the promise of improved outcomes for this disease