Predictive biomarkers for chemotherapies in pancreatic cancer

Pancreatic cancer is associated with high rates of mortality especially due to advanced stages of diagnosis. Adjuvant chemotherapy role is thus essential in the attempt to downstage the tumoral grade. In cases of locally advanced tumors, this step could be followed by curative surgical resection. Characterization of predictor biomarkers for adjuvant chemotherapy has drawn increasing interest in molecular biology research of pancreatic cancer. Personalized treatment is one of the solutions proposed for advancing towards a better outcome. In this paper we discuss available predictor biomarkers with focus upon gemcitabine and FOLFIRINOX (5-fluoro uracil (5-FU), irinotecan and oxaliplatin) chemotherapy regimens, present approaches in advanced pancreatic cancer. Many data are current available in relation with gemcitabine chemotherapy regimen, where biomarkers like ribonucleotide reductase large subunit (RRM1), human equilibrative nucleoside transporter-1 (hENT1), deoxycytidine kinase (dCK), human antigen R (HuR), and secreted protein acidic rich in cysteine (SPARC) were proposed. Regarding the response to FOLFIRINOX components, other markers such as thymidylate synthethase (TS), topoisomerase I, and excision repair cross-complementation 1 (ERCC1) or KRAS mutation status were also investigated.