The Hallmarks of Pancreatic Cancer

Pancreatic cancer is a complex disease and knowledge about precursor lesions, its molecular biological properties and tumorigenesis has considerably grown. Especially during the last decade, new insights into the molecular biology of PDAC helped to generate a better understanding of the disease development. Four driver genes were identified (KRAS oncogene, CDKN2A, p53, and SMAD4 tumor suppressor genes) but besides those, a large number of infrequently mutated genes dominate the mutation spectrum within PDAC. Apart from sequential tumorigenesis, chromothripsis has emerged as an underlying key mechanism for PDAC development. One key characteristic of PDAC is its dense stroma that is partly responsible for chemotherapy resistance. Pancreatic cancer has a huge potential for metastasis and one underlying mechanism, though controversially discussed, is epithelial to mesenchymal transition (EMT).