Peptides as integrative modulators for clinical prognosis and targeted therapy in pancreatic cancer

Pancreatic cancer remains a formidable global health challenge, ranking as the twelfth most common malignancy yet claiming an outsized toll with dismal 5-year survival rates 13.3%, largely due to late-stage diagnosis and limited therapeutic options. This comprehensive review delves into the transformative potential of peptides as innovative biomarkers and prognostic indicators, addressing the critical gaps in early detection and personalized management of this aggressive disease. Drawing from cutting-edge research in molecular oncology, proteomics, and bioinformatics, this paper highlights key genetic drivers such as KRAS, TP53, CDKN2A, and SMAD4 mutations that fuel Pancreatic cancer progression and stromal desmoplasia. Diverse peptide sources, including tumor-derived neoantigens, stromal remodeling fragments, and immune-modulating signals and their release mechanisms via ectodomain shedding and exosomes, were explored. Emphasizing advanced discovery pipelines, from mass spectrometry-based proteomics to immunoassays and machine learning-driven validation, current work spotlights promising candidates like PF4, PRO-C11-511, and CXCL7, which enhance diagnostic accuracy (AUC up to 0.961) and predict outcomes when integrated with established markers like CA19-9. By overcoming limitations of current biomarkers, such as low specificity and stage-dependency. This review underscores peptides' role in revolutionizing precision oncology, paving the way for non-invasive screening, targeted therapies, and improved survival in pancreatic cancer patients.