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Mota Reyes, C.* ; Goetz, M.R.* ; Algül, H.* ; Lesina, M.* ; Dogruoez, A.* ; Gürcinar, I.H.* ; Istvanffy, R.* ; Müller, C.M.* ; Yöndem, E.* ; Zschäpitz, D.* ; Friess, H.* ; Falcomatà, C.* ; Gaida, M.M.* ; Görgülü, K. ; Gültekin, Y.* ; Hasselluhn, M.C.* ; Olive, K.P.* ; Kalluri, R.* ; Kalluri, V.S.* ; Kiemen, A.* ; Wood, L.D.* ; Kim, P.* ; Lee, S.W.* ; Nam, D.* ; Yu, P.* ; Maitra, A.* ; Müller, S.* ; Pasca Di Magliano, M.* ; Rad, R.* ; Saur, D.* ; Vander Heiden, M.G.* ; Vormehr, M.* ; Karakas, D.* ; Ceyhan, G.O.* ; Demir, I.E.*

Pancreatic ductal adenocarcinoma: The Vision of Heracles.

Cancer Cell 44, 1721-1726 (2026)
DOI
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.
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Publication type Article: Journal article
Document type Comment, Opinion
ISSN (print) / ISBN 1535-6108
e-ISSN 1878-3686
Journal Cancer Cell
Quellenangaben Volume: 44, Issue: 9, Pages: 1721-1726 Article Number: , Supplement: ,
Publisher Elsevier
Publishing Place Cambridge, Mass.
Reviewing status Peer reviewed