Pancreatic ductal adenocarcinoma: The Vision of Heracles
Cancer Cell, vol.44, no.9, pp.1721-1726, 2026 (SCI-Expanded, Scopus)
- Publication Type: Article / Technical Note
- Volume: 44 Issue: 9
- Publication Date: 2026
- Doi Number: 10.1016/j.ccell.2026.07.014
- Journal Name: Cancer Cell
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, Chemical Abstracts Core, EMBASE, MEDLINE
- Page Numbers: pp.1721-1726
- Acibadem Mehmet Ali Aydinlar University Affiliated: Yes
Abstract
Pancreatic ductal adenocarcinoma (PDAC) remains among the deadliest malignancies, as tumors evolve faster than therapies. Resistance is ecological, not merely KRAS driven, involving overlooked players like high-grade pancreatic intraepithelial neoplasias (PanINs), peripancreatic fat, stromal mechanics, myeloid-neural circuits, metabolic rewiring, and systemic host responses. We propose precision interception targeting PanIN/intraductal papillary mucinous neoplasm (IPMN) biology, spatial-functional-proteogenomic classification beyond transcriptomics, the Heracles Protocol (measure, prime, strike, and adapt), and integrated technologies from AI pathology to exosomal delivery and CRISPR-based synergy mapping, together making PDAC more tractable.