Mutational and transcriptome based sub-classification of pancreatic cancer: are we there yet?

With a 5-year survival rate of ~8% (1) and limited therapeutic options, pancreatic cancer takes an enormous economic, financial and emotional toll on the patients and the caregivers alike. Resistance to standard cytotoxic chemotherapies, which have been the game changer in many diseases including breast cancer, makes treatment of pancreatic cancer an enormous challenge. Efforts at targeted therapies in this disease have met with failure, possibly due to incomplete understanding of its pathogenesis (2). Moreover, unique stromal biology poses additional challenge in design and delivery of standard as well as targeted therapies. To change the course of this difficult disease, a detailed understanding of the pathogenesis, mutational landscape, stromal biology, immune microenvironment and recurrence mechanisms is needed. In such a background, the genomic analysis done by Bailey et al. (3) provides an important insight into the molecular biology and taxonomy of this tumor and has huge translational importance.