{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:03:24Z","timestamp":1785402204129,"version":"3.56.0"},"reference-count":95,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Polish Society of Oncology","award":["K\/DAR\/000002"],"award-info":[{"award-number":["K\/DAR\/000002"]}]},{"name":"Polish Medical Research Agency","award":["KPOD.07.07-IW.07-00238\/24"],"award-info":[{"award-number":["KPOD.07.07-IW.07-00238\/24"]}]},{"award":["KPOD.07.07-IW.07-00238\/24"],"award-info":[{"award-number":["KPOD.07.07-IW.07-00238\/24"]}],"id":[{"id":"https:\/\/ror.org\/026nedj88","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Pancreatic ductal adenocarcinoma (PDAC) exhibits high post-resection relapse and early systemic dissemination rates. The level of circulating tumor cells (CTCs) correlates with early metastatic failure, motivating CTC interception strategies. Methods: In this hypothesis-driven review, we synthesized the contemporary evidence on PDAC staging and therapy, CTC detection (including portal versus peripheral sampling), and circulating tumor DNA (ctDNA)-based minimal residual disease (MRD), and evaluated the translational rationale for CTC-targeted adoptive immunotherapy focusing on CEACAM6 and CAR-T cells. Results: Prospective studies report higher portal versus peripheral CTC yields and stronger associations with relapse; tumor-informed ctDNA positivity in peri-operative and surveillance windows predicts shorter disease-free survival. CEACAM6 is overexpressed in PDAC and linked to invasion and metastasis, supporting antigen selection. However, target overexpression alone does not establish clinical suitability for adoptive cell transfer. Consequently, its therapeutic implementation must contend with assay heterogeneity, on-target\/off-tumor risks, and the lack of interventional outcome data in PDAC, all of which remain key hurdles. Conclusions: CTC-targeting is biologically plausible and operationally measurable in PDAC. Consequently, a CEACAM6-directed CAR-T approach is proposed as a potential strategy for the interception of minimal residual disease (MRD). Randomized and biomarker-selected trials with composite MRD-clearance endpoints (CTC &lt; LOQ and ctDNA-negative) may be justified to validate this interventional hypothesis.<\/jats:p>","DOI":"10.3390\/cancers18111852","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T08:43:04Z","timestamp":1780648984000},"page":"1852","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Targeting Circulating Tumor Cells in Pancreatic Ductal Adenocarcinoma: Rationale, Current Evidence, and a CEACAM6 CAR-T Strategy"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3251-5984","authenticated-orcid":false,"given":"Marcin","family":"Piejko","sequence":"first","affiliation":[{"name":"3rd Department of General Surgery, Jagiellonian University Medical College, 31-202 Krakow, Poland"},{"name":"Jagiellonian Center for Clinical Trial\u2014Biobank, Jagiellonian University Medical College, 30-688 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolina","family":"Bak","sequence":"additional","affiliation":[{"name":"Jagiellonian Center for Clinical Trial\u2014Biobank, Jagiellonian University Medical College, 30-688 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Wierciak","sequence":"additional","affiliation":[{"name":"Jagiellonian Center for Clinical Trial\u2014Biobank, Jagiellonian University Medical College, 30-688 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Plutecka","sequence":"additional","affiliation":[{"name":"Division of Molecular Biology and Clinical Genetics, Jagiellonian University Medical College, 30-688 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Wilczynska-Zawal","sequence":"additional","affiliation":[{"name":"Jagiellonian Center for Clinical Trial\u2014Biobank, Jagiellonian University Medical College, 30-688 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6188-7328","authenticated-orcid":false,"given":"Malgorzata","family":"Osmola","sequence":"additional","affiliation":[{"name":"Maria Sklodowska-Curie Medical Academy in Warsaw, 03-411 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamil","family":"Rapacz","sequence":"additional","affiliation":[{"name":"Jagiellonian Center for Clinical Trial\u2014Biobank, Jagiellonian University Medical College, 30-688 Krakow, Poland"},{"name":"General, Oncological, Gastroenterological and Transplant Surgery Clinical Department, University Hospital in Krakow, 30-688 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek","family":"Kijowski","sequence":"additional","affiliation":[{"name":"Cell Bank, Malopolska Centre of Biotechnology, Jagiellonian University, 30-387 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9850-2206","authenticated-orcid":false,"given":"Patrycja","family":"Mensah-Glanowska","sequence":"additional","affiliation":[{"name":"Department of Hematology, Jagiellonian University Collegium Medicum, University Hospital in Cracow, 30-688 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0244-7629","authenticated-orcid":false,"given":"Antoni","family":"Szczepanik","sequence":"additional","affiliation":[{"name":"3rd Department of General Surgery, Jagiellonian University Medical College, 31-202 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek","family":"Sierzega","sequence":"additional","affiliation":[{"name":"1st Department of Surgery, Faculty of Medicine, Jagiellonian University Medical College, 30-688 Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"ref_1","first-page":"12","article-title":"Cancer statistics, 2024","volume":"74","author":"Siegel","year":"2024","journal-title":"CA Cancer J. 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