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Vol. 56. Issue 1.
Pages 32-44 (January - March 2023)
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Vol. 56. Issue 1.
Pages 32-44 (January - March 2023)
Review
Expert consensus of the Spanish Society of Pathology and the Spanish Society of Medical Oncology on the determination of biomarkers in pancreatic and biliary tract cancer
Consenso de Expertos de la Sociedad Española de Patología y la Sociedad Española de Oncología Médica sobre la determinación de biomarcadores en el cáncer de páncreas y vías biliares
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Ruth Veraa, Carolina Ibarrola-de Andrésb, Jorge Adevac, Judith Pérez-Rojasd, Pilar García-Alfonsoe, Yolanda Rodríguez-Gilb, Teresa Macarullaf, Teresa Serrano-Piñolg, Rebeca Mondéjarh, Beatriz Madrigal-Rubialesi,
Corresponding author
a Navarra University Hospital, Spanish Society of Medical Oncology (SEOM), Pamplona, Spain
b 12 de Octubre University Hospital, Spanish Society of Pathology (SEAP), Madrid, Spain
c 12 de Octubre University Hospital, Spanish Society of Medical Oncology (SEOM), Madrid, Spain
d La Fe University and Polytechnic Hospital, Spanish Society of Pathology (SEAP), Valencia, Spain
e Gregorio Marañón University Hospital, Spanish Society of Medical Oncology (SEOM), Madrid, Spain
f Vall d’Hebron University Hospital, Spanish Society of Medical Oncology (SEOM), Barcelona, Spain
g Bellvitge University Hospital, Spanish Society of Pathology (SEAP), Barcelona, Spain
h La Princesa University Hospital, Spanish Society of Medical Oncology (SEOM), Madrid, Spain
i Río Hortega University Hospital, Spanish Society of Pathology (SEAP), Valladolid, Spain
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Abstract

Pancreatic cancer and biliary tract cancer have a poor prognosis. In recent years, the development of new diagnostic techniques has enabled the identification of the main genetic alterations involved in the development of these tumours. Multiple studies have assessed the ability to predict response to treatment of certain biomarkers, such as BRCA in pancreatic cancer, IDH1 or FGFR2 in biliary tract cancer and microsatellite instability or NTRK fusions in an agnostic tumour fashion.

In this consensus, a group of experts selected by the Spanish Society of Medical Oncology (SEOM) and the Spanish Society of Pathology (SEAP) reviewed the role played by these mutations in the process of carcinogenesis and their clinical implications. Based on their results, a series of recommendations are made to optimize the determination of these biomarkers and thus help standardize the diagnosis and treatment of these tumours.

Keywords:
Molecular diagnosis
Targeted therapies
Prognostic value
Predictive value
Pancreatic cancer
Biliary tract cancer
Resumen

El cáncer de páncreas y el de vías biliares son tumores de mal pronóstico. En los últimos años, el desarrollo de nuevas técnicas diagnósticas de biología molecular ha permitido conocer las principales alteraciones génicas implicadas en el desarrollo de estos tumores. Múltiples estudios han evaluado el carácter predictivo de respuesta a tratamiento de determinados biomarcadores, como BRCA en cáncer de páncreas, IDH1 y FGFR2 en tumores de vía biliar; y la inestabilidad de microsatélites y las fusiones de NTRK, para predecir la respuesta al tratamiento.

En este consenso, un grupo de expertos seleccionado por la Sociedad Española de Oncología Médica (SEOM) y la Sociedad Española de Anatomía Patológica (SEAP) ha revisado el papel que desempeñan estas mutaciones en el proceso de carcinogénesis y sus implicaciones clínicas. Como resultado, en este artículo se proponen una serie de recomendaciones para optimizar la determinación de estos biomarcadores, con el fin de fomentar la estandarización en el diagnóstico y el tratamiento de estos tumores.

Palabras clave:
Carcinogénesis
Diagnóstico molecular
Mutaciones
Terapias dirigidas
Valor pronóstico
Valor predictivo

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