Study suggests new potential strategy to fight against pancreatic cancer
A University of Michigan-led study is shedding new light on the way pancreatic cancer cells turn nearby connective tissue cells into co-conspirators in their deadly growth.
The findings, which appear in Nature Metabolism, also suggest a new potential strategy against pancreatic cancer by identifying critical components of metabolic cross talk between cells that might be attacked with new therapies, starving the cancer cells of vital nutrients.
Pancreatic cancer has been particularly resistant to even the best modern treatments -; the five-year survival rate stands at just 10%.
Ipsen scores FDA fast-track for Onivyde in first-line pancreatic cancer
The FDA designation will review the use of Onivyde (liposomal irinotecan) in combination with 5- fluorouracil/leucovorin (5-FU/LV) and oxaliplatin (OX), also known as Nalirifox, in patients with previously untreated, unresectable, locally advanced and metastatic pancreatic ductal adenocarcinoma (PDAC).
The fast-track programme aids the development and also expedites the review of drugs that are designed to treat serious medical conditions and have the potential to address an unmet medical need.
Pancreatic cancer is a rare type of cancer and carries a poor prognosis in the majority of cases. Of the 57,600 people with pancreatic cancer in the US, over half are diagnosed with metastatic disease, which carries an overall five-year survival rate of just 3%.
Researchers find a new therapeutic target in pancreatic cancer
The development of pancreatic cancer is driven by co-existing mutations in an oncogene involved in controlling cell growth, called KRAS, and in a tumor suppressor gene, called p53. But how these mutations cooperate to promote cancer is unknown. A new study co-led by Steven Leach, MD, Director of Dartmouth’s and Dartmouth-Hitchcock’s Norris Cotton Cancer Center (NCCC), uncovers a direct link between these mutations and the mechanism that regulates cell activity, providing insight for future development of therapeutics that could hit this newly found target in pancreatic cancer.
The study is co-led by Leach; Omar Abel-Wahab, MD, Associate Member in the Human Oncology and Pathogenesis Program at Memorial Sloan Kettering Cancer Center (MSKCC); and Luisa Escobar-Hoyos, Ph.D., MSc, Assistant Professor of Therapeutic Radiology at Yale School of Medicine and former post-doc in the Leach laboratory at MSKCC. Dr. Escobar-Hoyos conceived of and performed the work and serves as lead author, while Dr. Leach serves as co-senior author and along with Dr. Abdel-Wahab supervised the work, both while at MSKCC and while at NCCC. “The most commonly mutated tumor suppressor gene in cancer, p53, dramatically rewires RNA splicing, the fundamental cell mechanism by which RNA is processed before being translated into protein. The rewiring is done in a manner that leads to further activation of the KRAS oncogene, the major ‘driver’ gene in human pancreatic cancer,” explains Leach.
Changing Lives Through Early Detection
No one is ever fully prepared to face a pancreatic cancer diagnosis, but in Scott Nelson’s case, the prognosis was devastating; the size and location of his tumor made it inoperable. Feelings of shock, disbelief and anger flooded this loving father’s mind as he thought about his three daughters—and their eventual life without him. But another feeling arose within Scott: determination. He sought a second opinion and joined a clinical trial using a combination of chemotherapy, immunotherapy and radiation. The combined treatment worked to shrink Scott’s tumor so he could then undergo life-saving surgery. Scott has now been disease-free for 15 years, grateful for the countless memories and milestones he’s experienced with his family and committed to advocating for other patients and supporting early detection research.
Ask The Experts: Pancreatic Cancer Research and Treatment During the COVID-19 Pandemic
In May, which happens to be Cancer Research Month, we co-hosted an Instagram Live with Stand Up To Cancer featuring our Chief Medical Advisor and Deputy Director of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Dr. Elizabeth Jaffee, and our Chief Scientist and Director of the Cold Spring Harbor Laboratory Cancer Center, Dr. David Tuveson. The experts answered questions submitted in advance from our pancreatic cancer community, such as how COVID-19 is affecting pancreatic cancer research, what precautions pancreatic cancer patients should take, and how doctors and hospitals are treating patients during the pandemic.
If you weren’t able to tune in to the Instagram Live, read on for the first in a three-part series on the discussion.
How have researchers been spending their time during the pandemic? What has COVID-19 taught them about pancreatic cancer research?
The coronavirus has had a drastic impact on how people live their lives and how workplaces operate while keeping people safe. The pandemic forced many researchers to reframe how their skills as cancer scientists could be applied to help patients during the pandemic. Dr. Jaffee is a world-class clinical trialist— a researcher who leads the study of a drug, procedure, or medical device to determine its safety and effectiveness in preventing, screening for, diagnosing or treating disease in people and to improve quality of life— who runs a laboratory and large clinical trials. As companies race to formulate a vaccine, a clinical trial approach will be needed to ensure it is safe for humans and potent enough to combat the virus.
“What I’ve seen is almost a flash mob mentality amongst the scientists and the clinicians in our country and in the world in a productive fashion. We didn’t show up for a party. We showed up for a problem,” said Dr. Tuveson. To that end, Dr. Tuveson notes that while researchers are lending a hand to fight the coronavirus, they haven’t stopped thinking about pancreatic cancer. “We’ve actually come up with new ideas while struggling to tackle the coronavirus, as odd as that may sound, because we’re talking to other scientists and other doctors who we don’t usually talk to. We’re learning new approaches from them, which are innovative. And in trying to develop new ways to diagnose or treat the coronavirus, we’re actually coming up with new ways to diagnose and treat pancreas cancer,” said Dr. Tuveson.
How are doctors and hospitals taking care of cancer patients during the pandemic?
Pancreatic cancer doesn’t take a break just because there is a pandemic, so researchers like Dr. Jaffee are still hard at work ensuring patients are receiving the necessary treatment and care, despite the challenges of COVID-19. “We know pancreatic cancer patients can’t wait, so when we get calls from new or current patients, we assess the situation, “ said Dr. Jaffee. “If we feel they can avoid coming into the hospital where they may be at higher risk for contracting COVID, then we recommend other options. For example, we can do teleconferences to discuss their problems and even order medications. We have been setting up our pharmacy to be able to send medications to patients at their home. So this is a way to make things easier,” she noted. In situations where patients must visit the hospital for treatment, Dr. Jaffee stressed every precaution is being taken—from social distancing and protective gear to screening patients at the door and limiting the number of people who can accompany the patient to maintain safety for patients and staff.
What if a patient needs surgery or chemotherapy treatment?
While some surgeries were halted during the pandemic, this was not the case for those with pancreatic cancer. “If you need surgery, we’re still trying to make sure we can do that surgery in a timely fashion because pancreatic cancer patients cannot wait for their treatment,” said Dr. Jaffee. For those already on a chemotherapy regimen, Dr. Jaffee stressed treatment is still ongoing and hospitals have implemented safety measures such as delivering chemotherapy medicine at home, when it is safe to do so.
How have clinical trials been affected by COVID-19?
We learned from Dr. Jaffee that while clinical trial enrollment has slowed during the pandemic, patients who were already in a clinical trial or those who desperately needed access were able to either continue or begin a trial. “This is an unprecedented time and it’s particularly difficult for cancer patients and definitely challenging for pancreatic cancer patients who just cannot wait to have their treatments,” said Dr. Jaffee. In the meantime, researchers have been hard at work to get new clinical trials ready and open for patients to have access to when things begin to resume. Data from trials has continued to be generated, allowing for more collaboration between researchers in the pancreatic cancer community. “We are making many strides in our research efforts in the clinics and lab and we want to make sure that this accelerated progress is not slowed,” said Dr. Jaffee.
While these last few months have been daunting for many—especially for pancreatic cancer patients who needed treatment—Lustgarten researchers have rallied together to continue the progress that’s been made in pancreatic cancer research for patients and their loved ones.
A Better Future For Families Impacted by Pancreatic Cancer
The GENERATE (GENetic Education, Risk Assessment, and TEsting) Study is designed for people who have a close relative with pancreatic cancer that may have been caused by an inherited mutation in a gene. The goal of this study is to improve genetic testing and cancer prevention in family members of pancreatic cancer patients. If a family member does have an inherited risk, there may be options for preventing cancer or detecting it early at a curable stage via regular cancer screenings.
To be eligible for the GENERATE Study, participants must:
Have a first-degree relative* who has (or had) pancreatic cancer or a second-degree relative* who has (or had) pancreatic cancer and has a known genetic mutation
Be able to provide the genetic test report of the family member with a genetic mutation (if genetic testing has been done in the family)
Not have had pancreatic cancer
Not have had genetic testing or counseling for cancer risk before
Have a healthcare provider and be willing to share genetic test results with that provider and the GENERATE Study team
Be willing to complete a series of questionnaires for up to 15 months
Be age 18 or older
Have a United States mailing address
Have Internet access
Research points to potential new treatment for pancreatic cancer
As the next step in finding a potential targeted treatment for pancreatic cancer, researchers at the University of Cincinnati are publishing a new study revealing how a combination therapy may improve outcomes for patients with this disease.
The study, led by graduate research assistant Kombo N’Guessan, Ph.D., and Xiaoyang Qi, Ph.D., professor in the Division of Hematology Oncology at the UC College of Medicine, will be published in the June 8 online edition of the journal Molecular Therapy.
“These research findings will help us lead a clinical trial with a combination therapeutic approach to treat pancreatic cancer patients,” says Qi, corresponding author on the paper and a member of the UC Cancer Center.
Researchers in this study have found that using a therapeutic compound, called SapC-DOPS, a nanovesicle (or a nanotechnology drug delivery system) made of microscopic components of a cell, to deliver a combined biomarker target therapy and standard chemotherapy for pancreatic cancer may show benefit to patients.
Revealed: How cancer develops resistance to treatment
Cancer cells can turn on error-prone DNA copy pathways to adapt to cancer treatment, a breakthrough study published in the journal Science has revealed. Bacteria use the same process, termed stress-induced mutagenesis, to develop antibiotic resistance.
The cells of the human body are constantly dividing, and each time need to copy a three billion-letter DNA code with high precision to ensure cell survival. The same is not true for cancers, researchers have discovered.
A team led by Professor David Thomas at the Garvan Institute of Medical Research has shown how a broad range of cancers, including melanoma, pancreatic cancer, sarcomas and breast cancer, generate a high number of errors when they copy their DNA when exposed to cancer treatments, leading to drug resistance.
Identifying Patients With Pancreatic Cancer Likely to Respond
The presence of either germline or somatic mutations that encode proteins involved in a form of DNA repair known as homologous recombination (HR) identifies patients with advanced pancreatic cancer who are going to respond best to first-line (1L) platinum therapy, new research shows.
From 5% to 9% of patients with pancreatic cancer harbor germline or somatic mutations in the core HR genes (BRCA1, BRCA2, PALB2).
So, Your State is Reopening. Here’s What You Need to Know.
As some states begin to lift the lockdown restrictions surrounding COVID-19, and businesses slowly start to reopen, you may wonder how to best approach venturing out. If you are a pancreatic cancer patient, survivor or caregiver, you’re likely concerned or anxious about how lifting these restrictions could affect you and those you love.
For those who are considered high risk for contracting COVID-19, which includes people over 65 and those with an underlying health condition (such as heart disease, diabetes, asthma, a lung condition or cancer), it is wise to be cautious. Experts advise those at high risk to continue taking additional precautions to limit your potential exposure to COVID-19, for which there is currently no vaccine.
We asked Patricia Gambino, a gastrointestinal nurse navigator specializing in pancreatic cancer at the Penn Pancreatic Cancer Research Center at the University of Pennsylvania, in Philadelphia, PA, about what precautions you and your loved ones should take in the coming weeks as cities and states reopen.
How should those at high risk of contracting COVID-19 approach reopening?
While the number of new diagnosis and deaths are on the decline in some states, COVID-19 is still active and present in many communities. For those who are especially vulnerable to COVID-19, like pancreatic cancer patients, they should continue to exercise the same precautions they took during the lockdown. This may mean sheltering at home, if possible, continuing good hand-washing hygiene, practicing social distancing by staying six feet away from others when they do have to go out, and wearing a mask when in situations where the recommended amount of social distancing is not possible, recommends Gambino.
Is there anything pancreatic cancer patients should avoid doing?
If possible, patients should still have their groceries and prescription medications delivered to their homes or have a loved one go out for them. “With COVID-19, it is important to avoid lines and crowds as the disease can spread from person to person, so it’s better if patients are not in situations where they are likely to come in contact with many other people,” said Gambino.
What about seeing my doctor or going for a follow-up appointment or scan?
Doctors’ offices and hospitals are taking every precaution possible, including limiting the number of people in their waiting rooms and how many people a patient can have accompany them to an appointment, or consolidating appointments to reduce multiple visits, said Gambino. If your doctor offers a telehealth option and your appointment can happen virtually, it’s still best to use this service for high-risk patients. Of course, if that isn’t feasible due to the treatment you are receiving or another issue that requires in-person attention, patients should continue to wear masks when visiting their doctor’s office or hospital.
My workplace is reopening. Is it safe for me to return to work?
This is a conversation patients should have with their doctor to see if he or she believes this is a safe option given the patient’s overall health. Patients should discuss with their doctor the kind of environment in which they work and should mention the following:
Type of office environment: Do you work in an office with a door? A cubicle in an open office?
How many people do you work with? Can you safely maintain social distancing guidelines?
What kind of daily interactions do you have at work? Just colleagues? Clients? Customers?
These questions will help patients and their doctor determine whether returning to work is a safe option. If cleared to return, patients should ensure their workspace is clean by using a disinfecting wipe when they arrive in the morning and have a mask and gloves on hand.
What precautions should my caregivers/family members who I live with take to continue to keep me safe, now that they might be going back to work/other activities and interacting with others?
Anyone coming into the house should change out of the clothing they were wearing outside as soon as they return and must be vigilant about their hand hygiene. Anyone who provides care to a high-risk patient should take extra precautions when outside the home and avoid high-traffic areas and crowds. Gambino suggests trying to visit places like parks and grocery stores either early in the morning or later in the day to avoid peak times.
What strategies would you recommend for helping cope with the anxiety many report feeling related to COVID-19?
It’s easy to feel isolated while social distancing, which is why staying connected to loved ones via social media or a video platform is critical. As a nurse navigator, Gambino talks to her patients about the importance of exercising, eating well, limiting how much time they spend watching the news each day, and maintaining a routine. “Getting up at the same time each day, taking a walk, or starting a hobby like gardening are all great ways to create a sense of normalcy during this time,” Gambino said.
For more useful information about COVID-19 and how it specifically impacts pancreatic cancer patients, visit our affiliate, Let’s Win! Pancreatic Cancer.