However, recent discoveries are providing hope to the patients, unveiling the causes and progression of the disease and in turn helping doctors for better detection and treatment. This could possibly help in prolonging life expectancy in patients diagnosed with pancreatic cancer.
Here are three recent discoveries offering new insight into pancreatic cancer:
1. Genetic markers predict patients’ outcome; help tailor therapies better
After surgical removal of pancreatic cancer tumours, the high recurrence rate is usually the biggest concern among patients. There is currently no effective way to predict when the recurrence will occur, consequently worsening survival among patients.
However, earlier this month, a study done by Dr Brian Wolpin, the director of the Gastrointestinal Cancer Centre at Dana-Farber Cancer Institute, and his team found four main driver genes associated with patients’ outcomes – namely, the KRAS, CDKN2A, SMAD4, and TP53 genes.
In the study, Wolpin’s team analysed protein expression and DNA alterations for the four genes, and found that patients with KRAS mutant tumours have the worse disease-free survival and overall survival, as compared to KRAS wild-type tumours. While more than 90% of the patients had KRAS mutation of some sort, different variations of the KRAS mutation were also linked to different outcomes regarding tumour recurrence and survival. This also applies to the other three genes.
This discovery unveils the genetics behind these tumours gives doctors a hand to tailor therapies better. “One place this work will continue is really trying to move from a place where everybody gets the same therapy, to where we can use the genetics of the tumour to tailor therapy more appropriately to the individual,” says Wolpin.
2. Robotic surgery driving effectiveness and convenience
Lengthy, open procedures and long recovery time are often issues related with conventional surgical technique. Today, advancements in robotics make surgery with minimally-invasive method possible.
Helen Byrne, a nurse who had been diagnosed with pancreatic cysts, is one of the first patients of Dr David Kooby, the Emory Winship Surgical Oncologist, to undergo robotic surgery to remove the pancreatic cysts. As one of Bryne’s cysts was in the head of the pancreas, the condition is more complex than usual. However, with robotics, it makes tiny movements such as, controlling tiny instruments and inserting a camera through keyhole incisions in the abdomen easier.
“I can use one instrument to retract an organ, two instruments to work with. I can decide where the camera is going to be. It has increased stability, and it has binocular vision so I can actually see in three dimensions,” says Dr Kooby.
However, this new technology requires specialised training and is considered to be a complicated procedure. Even so, this robotic surgery does not only benefit the doctors, as many patients also reported to have less pain, shorter hospital stay, and a faster recovery.
“Robotic surgery made a difference for me in my recovery and it hardly slowed me down at all,” says Byrne.
3. Chemotherapy breakthrough improves patients’ outcomes
The most commonly observed mutation (more than 95% of cases) involves the mutation of KRAS gene, which codes for a protein responsible for the activation of kinase enzymes, PAKs. PAK family plays a key role in regulating the cancer’s environment, growth and spread, thus could be an ideal target for chemotherapy.
Recently, researchers combined a PAK inhibitor PF-3758309 with gemcitabine chemotherapy in mouse models. The study found that the PAK inhibitor helped in suppressing pancreatic cancer growth, stimulating tumour immune responses, enhancing gemcitabine’s chemotherapy effect.
Although the new chemotherapy showed an enhanced effect in animal model, further investigations are needed to further improve the patients’ survival rate. The research team has now collected more than 100 tissue samples from patients undergoing pancreatic cancer surgery, and screened at-risk families to identify early detection markers.
“Improvements in treatments are needed. The use of PAK inhibitors appears in animal models to improve the response of chemotherapy through multiple mechanisms of action. We now need to further investigate this potential,” says Dr Mehrdad Nikfarjam, a pancreatic surgeon and researcher from the Department of Surgery and Austin Health, University of Melbourne. MIMS
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