Pancreatic Cancer Treatment

Pancreatic Cancer Treatment Outcome Predicted By Genetic Test

A genetic tool developed in Japan allows clinicians to determine which patients may benefit the most from pancreatic cancer surgery to remove advanced tumors after first undergoing treatment to shrink the tumors.

The tumor marker gene (TMG) model involves combining the patients’ genetics with that of their tumor and was able to differentiate between patients who did well after surgery and those who did not. The research team, led by Nagoya University, now wants to further develop the TMG model score they created and to validate it for potential wider use.

“We found that the TMG model could more accurately identify which patients would really benefit from surgery. This could prevent some from undergoing unnecessary procedures and offer surgical opportunities to others who might have been overlooked,” said lead investigator Haruyoshi Tanaka from the Department of Surgery at Nagoya University Hospital in a press statement.

The Pancreatic Cancer Action Network predicts that 67,440 Americans will be diagnosed with pancreatic cancer this year and 51,980 people are predicted to die from the disease. It is one of the deadliest cancers with 5-year survival rates ranging from 8-13% depending on the type of pancreatic cancer, mainly because it is often diagnosed at a late stage.

“Some patients with unresectable disease at diagnosis may achieve a remarkable response by multimodal therapy and undergo subsequent surgery (so-called ‘conversion surgery’),” write Tanaka and co-researchers in the British Journal of Surgery.

“However, determining the appropriate indications for conversion surgery often presents a formidable challenge.” New biomarkers for pancreatic cancer include carbohydrate antigen 19-9 (CA19-9), DUPAN-2, and FUT2 and FUT3 and tests for these biomarkers in the blood can detect pancreatic cancer with a good degree of accuracy.

CA19-9 and DUPAN-2 are glycoproteins produced by pancreatic cancer cells and FUT2 and FUT3 are enzymes produced by the body that modify the actions of these glycoproteins but are also active when no cancer is present.

In this study, Tanaka and colleagues tested the biomarker status of advanced pancreatic cancer patients undergoing pancreatectomy surgery after first receiving treatment to shrink their tumors. They found genetic differences between patients linked to disease status and created the TMG model based on their findings.

Overall, people with a high score on their model had a worse outcome than those with a low score even after successful surgery. Although further testing is needed, the researchers believe the TMG model could help personalize surgical timing or avoid unnecessary surgery in high-risk patients. It could also help select which patients would most benefit from conversion surgery.

Pancreatic cancer, tumor markers, chemotherapy, immunotherapy, pancreatic adenocarcinoma, cancer diagnosis, cancer staging, pancreatic tumors, KRAS mutation, CA19-9, Whipple procedure, metastasis, oncogene, radiotherapy, pancreatic ductal carcinoma, early detection, genetic predisposition, cancer biomarkers, palliative care, clinical trials

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