Role of endoscopic ultrasound in the age of personalized medicine

Personalized medicine (PM) requires the definition of the molecular signature of a neoplasia in order to define patient response to treatments and give the right drug to the right patient at the right time. Endoscopic ultrasound (EUS) allows physicians to study and sample gastrointestinal tract and pancreatobiliary system lesions with a minimally invasive approach and EUS is part of the diagnostic flow chart to establish a PM for gastrointestinal stromal tumors (GIST) and pancreatic neuroendocrine neoplasia (pNEN). Furthermore, EUS is gaining more and more relevance for pancreatic adenocarcinoma, as somatic mutations and transcriptome analysis seem to be key when addressing this aggressive tumor. Establishing the proper method for EUS tissue sampling and conservation for these ancillary techniques is currently ongoing.