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PC features a complex tumor microenvironment whose cellular interactions shape tumor development, metabolism disruption, hyperproliferation, metastasis, and abnormal tumor-associated immunity. Omics sciences, especially metabolomics and genomics, enable finer subtype classification and support target discovery via pharmacogenomics, biomarkers from proteomics and metabolomics, and earlier diagnosis with radiomics. 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Understanding the Conundrum of Pancreatic Cancer in the Omics Sciences Era. Int. J. Mol. Sci. 2024, 25, 7623. [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)ijms25147623  \nAcademic Editors: Akira Sato and Tetsufumi Takahashi  \nReceived: 1 May 2024  \nRevised: 3 July 2024  \nAccepted: 8 July 2024  \nPublished: 11 July 2024  \nCopyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 CEMAD Centro Malattie dell’Apparato Digerente, Medicina Interna e Gastroenterologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; [alberto.nicoletti@policlinicogemelli.it](alberto.nicoletti@policlinicogemelli.it) (A.N.); [mattia.paratore@guest.policlinicogemelli.it](mattia.paratore@guest.policlinicogemelli.it) (M.P.); [fede.vitale1996@gmail.com](fede.vitale1996@gmail.com) (F.V.); [marcantonio.negri@policlinicogemelli.it](marcantonio.negri@policlinicogemelli.it) (M.N.); [giorgio.esposto@guest.policlinicogemelli.it](giorgio.esposto@guest.policlinicogemelli.it) (G.E.); [irene.mignini@guest.policlinicogemelli.it](irene.mignini@guest.policlinicogemelli.it) (I.M.); [antonio.gasbarrini@unicatt.it](antonio.gasbarrini@unicatt.it) (A.G.); [lorenzo.zileridalverme@policlinicogemelli.it](lorenzo.zileridalverme@policlinicogemelli.it) (L.Z.D.V.)  \n2 Centro Pancreas, Chirurgia Digestiva, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; [giuseppe.quero@policlinicogemelli.it](giuseppe.quero@policlinicogemelli.it) (G.Q.); [sergio.alfieri@unicatt.it](sergio.alfieri@unicatt.it) (S.A.)  \n* [Correspondence: mariaassunta.zocco@unicatt.it](Correspondence: mariaassunta.zocco@unicatt.it)[ ](Correspondence: mariaassunta.zocco@unicatt.it)† These authors contributed equally to this work.  \nAbstract: Pancreatic cancer (PC) is an increasing cause of cancer-related death, with a dismal prognosis caused by its aggressive biology, the lack of clinical symptoms in the early phases of the disease, and the inefficacy of treatments. PC is characterized by a complex tumor microenvironment. The interaction of its cellular components plays a crucial role in tumor development and progression, contributing to the alteration of metabolism and cellular hyperproliferation, as well as to metastatic evolution and abnormal tumor-associated immunity. Furthermore, in response to intrinsic oncogenic alterations and the influence of the tumor microenvironment, cancer cells undergo a complex oncogene-directed metabolic reprogramming that includes changes in glucose utilization, lipid and amino acid metabolism, redox balance, and activation of recycling and scavenging pathways. The advent of omics sciences is revolutionizing the comprehension of the pathogenetic conundrum of pancreatic carcinogenesis. In particular, metabolomics and genomics has led to a more precise classification of PC into subtypes that show different biological behaviors and responses to treatments. The identification of molecular targets through the pharmacogenomic approach may help to personalize treatments.","cbCaia01N8U7QbjH","https://ap.wps.com/l/cbCaia01N8U7QbjH","pdf",761905,25,"English","# Abstract\n# Introduction","[{\"question\":\"What factors contribute to the poor prognosis of pancreatic cancer?\",\"answer\":\"Pancreatic cancer has an unfavorable outcome due to aggressive biology, absence of early clinical symptoms that delays diagnosis, and inefficacy of existing treatments.\"},{\"question\":\"How do omics sciences improve understanding and classification of pancreatic cancer?\",\"answer\":\"Metabolomics and genomics support more precise PC classification into subtypes with distinct biological behaviors and treatment responses.\"},{\"question\":\"What roles do key omics tools play in precision medicine for pancreatic cancer?\",\"answer\":\"Proteomics and metabolomics can identify novel biomarkers, radiomics supports earlier diagnosis via computational imaging analysis, and pharmacogenomic approaches help discover molecular targets to personalize therapy.\"}]","Understanding the Conundrum of Pancreatic Cancer in the Omics Sciences Era - review | PDF",1790021414,63]