Killer on the road?—cells from pancreatic preneoplastic lesions disseminate through pancreatic ducts on their way to cancer

Pancreatic ductal adenocarcinoma (PDAC) is ranked the fourth most common cause of cancer related deaths in western countries with a 5-year survival rate of less than 8% (1). It is estimated to be even the second most common cause by 2030 as there are no successful treatment options (2). Due to the lack of early and specific symptoms as well as non-invasive biomarkers, the majority of patients is diagnosed at an advanced and already metastasized disease stage, where palliative treatment remains the only option (3). Thus, in order to improve the dismal prognosis of PDAC patients, a much better understanding of PDAC evolution is urgently needed allowing earlier detection of the disease and providing novel therapeutic modalities.