Pancreatic cancer is currently the 4th leading cause of cancer death in Western societies. It has hit the headlines in recent years for causing the untimely deaths of Patrick Swayze, Alan Rickman and Aretha Franklin.
It is very aggressive and can be difficult to diagnose, as often it doesn’t cause many symptoms in the early stages. Tumours also give different symptoms depending on where in the pancreas they are located. Because of this, pancreatic cancer tends to be diagnosed at a later stage when it is difficult to treat.
Current treatments work only in a small fraction of people; most live for only 6 months after their diagnosis and only 3-4% survive for five years or more.
Professor Andrew Biankin, Regius Chair of Surgery at the University of Glasgow, explains how a precision medicine project, Precision-Panc, could help improve this bleak picture.
“Patients with pancreatic cancer simply don’t have time for treatments that don’t work,” explains Professor Biankin. “They often only get one chance. The aim of Precision-Panc is to use a precision medicine approach to quickly match patients to the treatments that are most likely to work for their specific type of pancreatic cancer, based on the tumour’s genetics. If we can do this, we can transform how we treat this dreadful disease.”
Because pancreatic cancer is so aggressive, and standard chemotherapy often does not work, many patients want to join clinical trials for new experimental treatments. However, because every cancer is different, it can be difficult to find the right clinical trial for each patient, get them through the current system and enrolled in a trial. By the time this happens it’s often too late because the patient is no longer well enough for the trial.
“We urgently need to speed up this process, to enable more patients to join trials and try new treatments which could offer them more benefits than the current standard of care,” says Prof Biankin.
“We were awarded £10m from Cancer Research UK in 2017 – this investment allowed us to get a more detailed understanding of each individual patient’s cancer by analysing tumour biopsies and the DNA shed by the cancer into the patient’s bloodstream, as well as the interaction between cancer cells and the immune system,” explains Prof Biankin. “This detailed information allows us to find the right clinical trial for each patient as quickly as possible. It will also give us an avenue to fast-track new treatments which focus on specific groups of patients, for example those who have a specific genetic predisposition in their tumour.”
Patients at Glasgow Royal Infirmary and 8 other Precision-Panc centres across the UK can now opt to provide samples for the Precision-Panc project as part of their routine diagnostic care – making it easier for them to enter clinical studies without additional tests. These samples are subjected to molecular profiling, and the results used to match patients to the most appropriate available clinical trial. Linking clinical data with the patient’s unique molecular profiling data will also enable rapid new discoveries and enhance delivery of precision medicine to current and future patients.
Three clinical trials allied to Precision-Panc are now under way at the Beatson West of Scotland Cancer Centre in Glasgow and 7 other UK centres, with more centres to follow. These trials will recruit a total of 658 patients under the Precision-Panc umbrella. Each clinical trial will test new and combinations of drugs in specific types of patients.
As part of Precision-Panc, patients may also be helped onto other suitable clinical trials that are already up and running across the UK.
“What we really want at the end of Precision-Panc is for new drugs to be developed which will improve survival rates in all patients with pancreatic cancer,” says Prof Biankin. “I believe we’re on the cusp of making some incredible advances that will provide new treatment options to help people affected with this terrible disease.”
Collaborators: SMS-IC, NHS Scotland: Greater Glasgow and Clyde, The University of Glasgow and Aridhia Informatics Ltd.