Pancreatic Cancer Appears to be Different Disease in
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.
FDA approves test in humans using an OCT probe small enough to be inserted into pancreas through a biopsy needle:
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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
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
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 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.”
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).
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 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.
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.
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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