Routine genetic profiling in pancreatic cancer could save lives by matching the right patient to the right medicine at the right time.
In a study published in Gastroenterology, a team from UPMC and the University of Pittsburgh School of Medicine analyzed the genomes of 3,594 pancreatic tumors. The samples, which were provided by Foundation Medicine, were taken from patients from around the world.
They found that biomarkers suggesting the tumor would be suspectable to existing chemotherapy drugs were present in 17 percent of cases,1 opening the door to more personalized medicine approaches.
Lead author, Aatur Singhi, M.D., Ph.D., surgical pathologist at UPMC and assistant professor of pathology at Pitt, says: “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 all patients the same chemotherapy, we want to tailor a patient’s chemo to their tumor type. We would like to make molecular profiling standard-of-care for patients with pancreatic cancer.”2
No one size fits all approach
A “one-size-fits-all” approach to treating the cancer, which currently has a five-year survival rate of less than nine percent, would not improve prognoses, he says.
Senior author Nathan Bahary, M.D., Ph.D., oncologist at UPMC Hillman Cancer Center and associate professor of medicine at Pitt, says: “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.”2
The study also found evidence of inherited genes, including some in the breast cancer associated-BRCA family, that could predispose whole families to pancreatic cancer.
This finding could inform future screening policies and aid earlier detection of pancreatic cancer, which is often only found in its advanced stages and kills 75 percent of patients within a year of diagnosis.1
Need for early detection
“To avoid the perils of over-diagnosis and focus early detection efforts on individuals deemed to be at higher than average risk, we need to first define who those subsets of individuals are and quantify the degree of elevated risk,” says the study.1
These latest results build on previous work by Singhi’s team to develop a test, PancreaSeq, which evaluates common pancreatic cysts to identify those that may progress to cancer. The new biomarkers can be added to the PancreaSeq platform, which is already being used by several institutions including UPMC.
While the authors point out there is still a lot of work to be done in terms of quantifying and addressing risk factors, the study offers real promise in terms of improving outcomes in pancreatic cancer, they say.
“We believe 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,” notes Siraj Ali, M.D., Ph.D., senior director of clinical development at Foundation Medicine.2
- Singhi, A. D., Koay, E. J., Chari, S. T., & Maitra, A. (2019). Early Detection of Pancreatic Cancer: Opportunities and Challenges. Gastroenterology. Retrieved from https://www.gastrojournal.org/article/S0016-5085(19)30358-0/fulltext
- Genomics could better match treatments to pancreatic cancer patients. (2019, March 15). Retrieved from https://www.eurekalert.org/pub_releases/2019-03/uop-gcb030119.php