Evidence map›Paper›PMID 42730833›Full record

ReviewMolecular biology reports2026

Overcoming cancer resistance in pancreatic cancer: toward dynamic precision oncology.

Takehiro Okabayashi, Motoyasu Tabuchi, Teppei Tokumaru, Sunao Uemura, Shuta Tamura

Abstract readReview
PubMed Publisher
In one paragraph

Review in Molecular biology reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Takehiro OkabayashiDepartment of Gastroenterological Surgery, Kochi Health Sciences Center, Kochi, Japan. tokabaya@gmail.com.ORCID https://orcid.org/0000-0002-4829-4306
Motoyasu TabuchiDepartment of Gastroenterological Surgery, Kochi Health Sciences Center, Kochi, Japan.
Teppei TokumaruDepartment of Gastroenterological Surgery, Kochi Health Sciences Center, Kochi, Japan.
Sunao UemuraDepartment of Gastroenterological Surgery, Kochi Health Sciences Center, Kochi, Japan.
Shuta TamuraDepartment of Gastroenterological Surgery, Kochi Health Sciences Center, Kochi, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Pancreatic ductal adenocarcinoma (PDAC) remains a highly lethal malignancy, largely because of its profound and evolving therapeutic resistance. Resistance is not determined by a single molecular alteration but arises from interconnected mechanisms, including intrinsic resistance, treatment-induced adaptive resistance, acquired resistance, genomic evolution, clonal selection, cancer stemness, phenotypic plasticity, metabolic adaptation, and tumor microenvironment-mediated effects. Emerging therapeutic approaches targeting KRAS/RAS signaling, stromal and immune components, metabolic dependencies, and DNA damage repair pathways offer opportunities to address these mechanisms, although durable efficacy remains limited by biological heterogeneity and adaptive responses. In this review, we examine therapeutic resistance as an evolutionary and multidimensional process and summarize emerging strategies for overcoming resistance. We further propose a Dynamic Precision Oncology (DPO) framework that extends conventional precision oncology beyond baseline molecular profiling by integrating longitudinal assessment of tumor genomics, circulating tumor DNA, CA19-9, imaging, radiomics, and clinical characteristics. This framework emphasizes iterative detection and characterization of emerging resistance, mechanism-informed treatment adaptation, and subsequent reassessment rather than automatic treatment modification based on a single biomarker. DPO may provide a conceptual framework for integrating evolving tumor biology into treatment decision-making, while prospective studies are needed to validate biomarkers, define actionable thresholds, and determine whether longitudinal resistance-guided strategies improve clinical outcomes in PDAC.

Indexed as

Carcinoma, Pancreatic DuctalDrug Resistance, NeoplasmPancreatic NeoplasmsPrecision MedicineBiomarkers, TumorHumansTumor MicroenvironmentBiomarkers, TumorArtificial intelligenceCancer stem cellsDynamic precision oncologyLiquid biopsyPancreatic ductal adenocarcinomaPrecision oncologyTherapeutic resistanceTumor evolutionTumor microenvironment

Identifiers

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.