Adenosquamous Carcinoma of the Pancreas (PAASC)
Overview
Adenosquamous carcinoma of the pancreas is a rare biphasic malignancy classified under Pancreatic Cancer in OncoTree (parent: PANCREAS). It accounts for ~1–4% of all exocrine pancreatic cancers and is histologically defined by the presence of both glandular (adenocarcinoma) and squamous components. PAASC is generally associated with a worse prognosis than conventional pancreatic ductal adenocarcinoma (PAAD).
Cohorts in the corpus
- paad_utsw_2015 — 11 PAASC cases (10% of 109 resected cases) included in a microdissected whole-exome sequencing cohort; mostly stage I–II. PMID:25855536
Recurrent alterations
- MYC focal amplification at 8q24.13 is uniquely associated with poor overall survival (P=0.0013) and is significantly over-represented in PAASC relative to ductal carcinoma NOS (PAAD) histology in a 109-case WES cohort; confirmed by FISH with no MYC translocation detected; also detectable in PanIN precursors. PMID:25855536
- PAASC shares the canonical PAAD driver backbone (KRAS 92%, TP53 50%, SMAD4 19%, CDKN2A/B 36%) in the same mixed-histology cohort. PMID:25855536
Subtypes
Therapeutic landscape
- MYC amplification nominates CDK9 (PHA767491) and BET-bromodomain inhibitors (jq1) as candidate targeted therapies in PAASC. PMID:25855536
Sources
- PMID:25855536 — Witkiewicz et al. Nature Communications 2015. WES of 109 microdissected pancreatic carcinomas including 11 PAASC.
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