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New insight into pancreatic cancer scar tissue offers potential treatment targets

The first study in the world to take a detailed look at scar tissue that surrounds pancreatic cancer tumours – also known as the stroma - has revealed a range of different scar tissue types that could help clinicians predict which patients will respond best to particular treatments.

The stroma is a particular problem in pancreatic cancer, where it forms the largest proportion of tumour volume out of any type of cancer. The thick scar tissue forms a protective wall around the cancer, hampering treatments including chemotherapy, immunotherapy or radiotherapy.

The research team, led by Queen Mary University of London, The Institute of Cancer Research, London, Beaujon University Hospital (INSERM), Paris, and Barts Health NHS Trust, hope that the research could lead to tailor-made treatments in the future that target the different types of scar tissue.

Looking at pancreatic cancer samples from 16 patients in the UK, Germany and Australia, and 50 surgically resected tumours from France, the study shows that there are at least four different types of scar tissue, and each may influence the cancer in a different manner.

Finding which type of scar tissue is predominant in a patient may indicate to clinicians which patients will do well with treatment and which will not. The work paves the way for researchers to develop new treatments which are tailor-made for a particular patient.

Co-lead researcher Professor Hemant Kocher from Queen Mary University of London and Barts Health NHS Trust (pictured), said: “Scar tissue is a huge barrier in treating pancreatic cancer, where it can form up to 90 per cent of the tumour volume, but it is still so poorly understood.

“Our ongoing mission is to fully understand how the scar tissue influences cancer behaviour so that we can develop more effective treatments for patients with this disease, where sadly very few are successful.”

Co-lead researcher Dr Anguraj Sadanandam from The Institute of Cancer Research in London, said: “Identifying the four types of scar tissue in our new study will help us better understand how scar tissue and tumour cells interact in pancreatic cancer, and offers new insights into how to tackle this devastating disease.

The study is published in the Journal of Pathology.