Lecture : The overwhelming majority of pancreatic cancer patients present with advanced disease, and their tumor tissues are rarely sampled, beyond the minimal amounts of fixed cells required to render a cancer diagnosis. As a result, an opportunity to generate living “personalized” models from each patient’s tumor, in order to perform more sophisticated molecular analyses and drug sensitivity testing, is almost always missed. It is important to develop an innovative pipeline for characterizing a patient’s pancreatic cancer without the need for obtaining tissue biopsies and facilitating the isolation of live pancreatic cancer cells released from the tumor into the blood circulation (“circulating tumor cells” or CTCs). The CTCs can then be expanded in vitro as an immortalized model of their cancer, and utilized as a representative of tumor heterogeneity for a variety of treatment decision-making and disease monitoring approaches. Importantly, this liquid biopsy requires no more than a single tube of blood, which can be obtained during a routine blood draw at each re-staging. A device has been engineered which readily yields live pancreatic cancer cells when isolating CTCs from the blood of cancer patients. Serial blood samples, which are obtained peripherally in the surgical and metastatic patients, determine whether re-appearance or evolution of CTCs (single or clusters) precedes disease recurrence or progression visible on imaging. Another innovative aspect of CTCs study is to identify molecular abnormalities in single CTCs, which provide unprecedented insights into how these abnormalities impact disease outcome in the patient, and the responses to therapy. I suggest the development of the practical framework for clinical implementation of a CTC platform in pancreatic cancer patients, with direct implications for diagnosis and therapy. References) 1. Cayrefourcq, L., et al. Establishment and characterization of a cell line from human circulating colon cancer cells. Cancer Res. 2015;75:892-901. 2. Maheswaran, S. and D.A. Haber. Ex Vivo Culture of CTCs: An Emerging Resource to Guide Cancer Therapy. Cancer Res. 2015;75:2411-5. 3. Lapin M, Tjensvoll K, Oltedal S, et al. Single-cell mRNA profiling reveals transcriptional heterogeneity among pancreatic circulating tumour cells. BMC Cancer. 2017 May 31;17(1):390.