Advancing precision medicine in pancreatic cancer using endoscopic ultrasound guided biopsy

Pancreatic cancer (PC) is an aggressive disease with a poor prognosis. While great advances have been made in the management of many cancers by routinely screening tumours for specific molecular changes which predict for response to targeted therapies, no such “precision medicine” approach is currently standard of care in PC. This thesis aims to broaden the use of endoscopic ultrasound guided fine needle aspiration biopsies, a common diagnostic method, to advance precision medicine in PC. This thesis characterises a genetic signature of PC, identifies molecular markers and a novel immune target which may inform precision medicine, and reports on a clinical trial of precision therapy.