Pancreatic cancer has a five-year survival rate of less than nine percent. Researchers at UPMC and the University of Pittsburg School of Medicine is seeking to improve those odds by looking at genetic signatures in the largest study of its kind that could be used to improve the matching of drugs to patients and in early detection.
The study was published in the journal of Gastroenterology and it involved sifting through the genomes of thousands of tumors sampled from all over the world. In 17 percent of the cases, there was a genetic flag that indicated the tumor should be susceptible to existing chemotherapy drugs. Additionally, researchers discovered supporting evidence for heritable genes. This included some in the BRACA family associated with breast cancer, which can predispose entire families toward pancreatic cancer.
“People have been looking for such markers for a long time, and our study shows that it’s possible to break pancreatic cancer patients into different treatment buckets,” according to senior author Nathan Bahary, M.D., oncologist at UPMC Hillman Cancer Center and associate professor of medicine at Pitt.
One of the reasons pancreatic cancer is lethal is that the majority of patients are often diagnoses late in the disease course and frequently present with inoperable tumors at the time of diagnoses. In some patients, it is possible to shrink the tumor with existing chemotherapy drugs, however, in 75 percent of patients die within a year of diagnoses. Unfortunately, there is no way to know in advance which patients will respond to which drugs.
“Every pancreatic cancer is different, and performing molecular profiling of each patient’s tumor could help determine the best treatment options. Rather than blindly giving patients the same chemotherapy, we want to tailor a patient’s chemo to their tumor type. A one-size-fits-all approach isn’t going to work. Therefore, we would like to make molecular profiling standard-of-care for patients with pancreatic cancer,” according to lead author Aatur Singhi, M.D., surgical pathologist at UPMC and assistant professor of pathology at Pitt.
The study, conducted by Singhi and Bahary, characterized the genome of 3,594 pancreatic tumor samples from patients around the world, provided by collaborators at Foundation Medicine.
“We believe that this is the largest study in pancreatic cancer conducted using comprehensive genomic profiling to identify a broad set of genomic alterations and ultimately, therapeutic targets, in this difficult-to-treat disease,” stated by Siraj Ali, M.D., senior director of clinical development at Foundation Medicine.
Other than shrinking tumors with personalized chemotherapy, increased pancreatic screenings can also increase pancreatic cancer survival rates, however, the problem is that pancreatic cysts are common and do not all lead to cancer.
Previously, Singhi and colleagues developed a clinical molecular test called the PancreaSeq to evaluate common pancreatic cysts and identify with cases could progress to cancer. Singhi and Bahary’s discovered biomarkers can be added to the PancreaSeq platform, already being used by several institutions, including UPMC.
By Jeanette Smith
R&D: Genomics Could Better Match Treatments to Pancreatic Cancer Patients
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