Genome-Informed Treatment Improves Survival in Pancreatic Cancer

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Treatment based on genomic profiling has potential to improve pancreatic cancer treatment outcomes.
Treatment based on genomic profiling has potential to improve pancreatic cancer treatment outcomes.

Treatment based on genomic profiling, also known as precision medicine, may hold the promise of improved outcomes for a subset of patients with pancreatic cancer. Pancreatic cancer is the third leading cause of cancer deaths in the United States and with a survival rate of just 8% current treatments are largely ineffective. Genomic profiling, according to a pair of recent studies published by researchers at the University of Pittsburgh and the University of Pittsburgh Medical Center (UPMC) may be the key to more effective pancreatic cancer treatment.

The first study investigated genomic changes in 100 patients with gastrointestinal cancer including colorectal and pancreatic cancers. Common mutations in each cancer were identified and recommendations could be made for 38% of patients. However, due to rapid disease progression, only 14% of patients could follow the recommended treatment. Half of the patients following genome-informed therapy treatment showed improved overall survival. One patient had a mutation in the ALK gene, a gene that is commonly implicated in other forms of cancer including breast, colon, and lung for which current drug treatments have been successful.1  

The second study investigated the genomic profile of more than 3000 patients with pancreatic cancer. Only 5 patients (0.2%) had mutations in ALK. Four of the 5 patients were treated with commonly used ALK inhibiting drugs. Positive effects including disease stability, tumor shrinkage, and lower levels of a pancreatic specific biomarker were observed in 3 patients.2

“Together, these 2 findings begin to capture the promise of precision medicine in pancreatic cancer, which has so far not experienced the same success with targeted treatments as other cancer types,” said the senior investigator of both studies, Nathan Bahary, MD, PhD, associate professor of medicine at the University of Pittsburgh, and co-director of the UPMC Pancreatic Cancer Center of Excellence. “The assessment of these actionable alterations is now part of routine pancreatic cancer care at UPMC.”

References

1. Dhir M, Choudry HA, Holtzman MP, et al. Impact of genomic profiling on the treatment and outcomes of patients with advanced gastrointestinal malignancies [published online December 28, 2016]. Cancer Med. doi: 10.1002/cam4.992

2. Singhi AD, Ali AM, Lacy J, et al. Identification of targetable ALK rearrangements in pancreatic ductal adenocarcinoma. J Natl Compr Canc Netw. 2017 May 5.

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