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Health & Medicine for Senior Citizens

Pancreatic Cancer Appears to be Different Disease in Different People

Study for international cancer study says each pancreatic patient may require a different treatment

Oct. 25, 2012 – Pancreatic cancer, which has the highest mortality rate of all the major cancers and is one of the few for which survival has not improved substantially over the past 40 years, appears to not be one disease, and people who appear to have the same cancer may need to be treated differently.

The large-scale study that defines the complexity of underlying mutations responsible for pancreatic cancers in more than 100 patients was published in Nature today. It is the fourth-leading cause of cancer death.

The analysis represents the first report from Australia’s contribution to the International Cancer Genome Consortium (ICGC), which brings together the world's leading scientists to identify the genetic drivers behind 50 different cancer types.

Professor Sean Grimmond, from the Institute for Molecular Bioscience (IMB) at The University of Queensland, and Professor Andrew Biankin, from The Kinghorn Cancer Centre at Sydney’s Garvan Institute of Medical Research/ St. Vincent’s Hospital led an international team of more than 100 researchers that sequenced the genomes of 100 pancreatic tumors and compared them to normal tissue to determine the genetic changes that lead to this cancer.

“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 tumors,” Professor Grimmond said.

 

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“So while tumors may look very similar under the microscope, genetic analysis reveals as many variations in each tumor 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.”

Professor Biankin said such individual genetic diagnoses and treatments represent the future of healthcare.

“In this study, we found a set of genes, the axon guidance pathway, that is frequently damaged in pancreatic cancer patients and is associated with a potentially poorer outcome for those patients. It is a new marker of pancreatic cancer that can be used to direct prognoses and treatments.

 “'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 in moving from population healthcare and a ‘one drug fits all’ model to personalized healthcare. First we must take the time to develop the necessary genetic knowledge and implement health systems to translate that knowledge effectively.”

Professors Biankin and Grimmond acknowledged the vital assistance of the Australian Pancreatic Cancer Genome Initiative, a network of more than 20 hospitals and research institutions Australia-wide, with over 200 members – surgeons, pathologists, nurses and researchers - that all contributed to the project (www.pancreaticcancer.net.au).

They also collaborated with colleagues from the Baylor College of Medicine and The Methodist Hospital Research Institute in Texas, the Ontario Institute for Cancer Research, Johns Hopkins University in Maryland, the University of California San Francisco, the University of Verona, the Cambridge Research Institute and the Sanger Centre in the UK.

The ICGC project is being funded through $27.5 million from the National Health and Medical Research Council of Australia (NH&MRC), its largest-ever single grant. NHMRC Chief Executive Officer, Professor Warwick Anderson said that “NHMRC is proud to have been the major funding contributor to this research, and I am delighted that breakthroughs have been made in understanding the genetic basis of this disease.

“This positive outcome is evidence of NHMRC supporting the very best research and researchers, and the importance of our involvement in strong national and international collaborations. “The ultimate goal of our funding is healthier citizens, both in Australia and overseas, and this research will certainly lead to a better understanding of this issue.”

Funding

As well as the NHMRC funding, we acknowledge the following additional funding support: Commonwealth Department of Innovation, Industry, Science, Research and Tertiary Education (DIISRTE); Australian Cancer Research Foundation (ACRF); Queensland Government (NIRAP); The University of Queensland; Cancer Council NSW; Cancer Institute NSW; Avner Nahmani Pancreatic Cancer Research Foundation; R.T. Hall Trust; Petre Foundation; Jane Hemstritch in memory of Philip Hemstritch; Gastroenterological Society of Australia (GESA); American Association for Cancer Research (AACR) Landon Foundation – INNOVATOR Award; Royal Australasian College of Surgeons (RACS); Royal Australasian College of Physicians (RACP); Royal College of Pathologists of Australasia (RCPA).

ABout International Cancer Genome Consortium (ICGC)

The International Cancer Genome Consortium (ICGC) has been organized to launch and coordinate a large number of research projects that have the common aim of elucidating comprehensively the genomic changes present in many forms of cancers that contribute to the burden of disease in people throughout the world.

The primary goals of the ICGC are to generate comprehensive catalogues of genomic abnormalities (somatic mutations, abnormal expression of genes, epigenetic modifications) in tumors from 50 different cancer types and/or subtypes which are of clinical and societal importance across the globe and make the data available to the entire research community as rapidly as possible, and with minimal restrictions, to accelerate research into the causes and control of cancer. The ICGC facilitates communication among the members and provides a forum for coordination with the objective of maximizing efficiency among the scientists working to understand, treat, and prevent these diseases.

About Garvan

The Garvan Institute of Medical Research was founded in 1963. Initially a research department of St Vincent's Hospital in Sydney, it is now one of Australia's largest medical research institutions with over 600 scientists, students and support staff. Garvan's main research programs are: Cancer, Diabetes & Obesity, Immunology and Inflammation, Osteoporosis and Bone Biology and Neuroscience. Garvan's mission is to make significant contributions to medical science that will change the directions of science and medicine and have major impacts on human health. The outcome of Garvan's discoveries is the development of better methods of diagnosis, treatment, and ultimately, prevention of disease.

About IMb

The Institute for Molecular Bioscience (IMB) is a research institute of The University of Queensland. It was founded in 2000 and aims to improve quality of life by advancing personalized medicine, drug discovery and biotechnology, specifically in the areas of cancer, pain, infection, childhood diseases, obesity, superbugs, diagnostics, agriculture and energy.

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