Pancreatic ductal adenocarcinoma: the role of circulating tumor DNA

Abstract. Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers in humans, and utilized treatments over the past decades have shown little evidence of improvement in survival. This lack of progress in PDAC treatment outcomes has largely been attributed to a variety of limitations in all phases of care. These limitations most notably include late diagnosis leading to limited treatment options and consequently poorer response to treatments and eventual outcomes. Clinical implications regarding the emergence of circulating tumor cells and DNA (ctDNA) have shown promise in augmenting each step in the management of PDAC. This paper will review the emergence of ctDNA and its value in detection of common PDAC DNA alterations, potential clinical implications and utility, followed by the current limitations and the next steps that need to be taken to translate its use into a standard of care