Lessons learned by features of pancreatic ductal adenocarcinoma and its tumor microenvironment

Pancreatic ductal adenocarcinoma (PDAC) is a notoriously treatment resistant malignancy with high rates of mortality (1). While complete surgical resection is the only current option for cure, chemotherapy remains the bedrock for disease management across all disease presentations (1-3). The molecular profiles of individual cancers can be utilized to direct therapeutic selection and improve survival, such as hormonal therapy for breast cancer or checkpoint inhibitors in microsatellite instability high colon cancers (4,5). Unfortunately, current oncologic guidelines fail to account for molecular tumor heterogeneity and patient individuality when selecting therapeutic regimens for PDAC.