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Landmark study advocates more personalised approach to pancreatic cancer treatment

30 October 2012

An Australian-led study which has sequenced the entire genome of 100 pancreatic tumours found so many different combinations of mutated genes, its authors conclude that pancreatic cancer should not be classed as a single disease.

The remarkable research project, published in the top international journal Nature, brought together over 100 researchers from around the world to determine the genetic factors that influence different types of cancer.

The landmark findings suggest that a move towards ‘personalized medicine’ might be more successful in treating pancreatic cancer than the current ‘one size fits all’ approach.

Says study leader Professor Sean Grimmon from the University of Queensland:

"We found over 2,000 mutated genes in total, ranging from the KRAS gene, which was mutated in about 90 per cent of samples, to hundreds of gene mutations that were only present in 1 or 2 per cent of tumours. So while tumors may look very similar under the microscope, genetic analysis reveals as many variations in each tumour as there are patients. This demonstrates that so-called 'pancreatic cancer' is not one disease, but many, and suggests that people who seemingly have the same cancer might need to be treated quite differently."

Co-author Professor Andrew Blankin from the Garvan Institute of Medical Research and St Vincent's Hospital in Sydney, believes that in the future, individual diagnoses and treatment plans for each patient will become the norm.

“'Personalized medicine', where the molecular profile of a patient is matched to the best treatment, is the way the world is moving for many diseases, not just cancer. The challenge now will be moving from population healthcare and a 'one drug fits all' model to personalized healthcare," he said.

Professor Blankin also noted that the study had revealed further new insights into the disease. "We found a set of genes called the axon guidance pathway that is frequently damaged in pancreatic cancer patients and is associated with potentially poorer outcomes for those patients. It is a new marker of pancreatic cancer that can be used to direct prognoses and treatments."

Research team member Dr Chris Scarlett from the University of Newcastle in Australia, added:

"We've unequivocally shown that it seems to be different in pretty much every individual, which is frightening in one way, but it's certainly something we can investigate further to try to more personalise or individualise treatment for these patients."

"This is only the tip of the iceberg, essentially," he said. "This is going to lead off into multiple, exciting and interesting and important studies to really understand what's going on with this horrible disease, and hopefully give us better strategies to improve our treatment options."

The project was funded by a grant of $27.5 million by the National Health and Medical Research Council of Australia. 

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