Monthly Archives: June 2015

Potential ‘Game-Changer’ for Treating Pancreatic Cancer


M.D. Anderson study called potential ‘game-changer’ for treating pancreatic cancer

M.D. Anderson researchers may be able to catch pancreatic tumors early

Researchers at M.D. Anderson Cancer Center believe they have found a path to early detection that could yield more effective treatment of pancreatic cancer, an illness so lethal that just 7 percent of patients survive for five years after their diagnosis.

In a study published in Wednesday’s issue of the science journal Nature, the researchers found patients with pancreatic cancer had certain particles in their bloodstream not found in healthy patients or in those with other types of pancreatic disorders. The presence of those particles could determine, with 100 percent accuracy, who had pancreatic cancer and who did not, the study found.

While the test must undergo more rigorous study before it can be used routinely, it could finally provide a reliable, noninvasive way of finding the cancer before it’s too late to treat it.

“If it pans out, it’s a game-changer,” said Dr. Raghu Kalluri, chair of cancer biology at M.D. Anderson and a co-author of the study, “and we’re aware that our patients really need that right now.”

The National Cancer Institute estimates 48,960 new pancreatic cancer cases will be diagnosed this year, and it will kill 40,560 people.

Pancreatic cancer has among the worst outcomes of any cancer. The pancreas is located deep within the body, so early tumors cannot be seen or felt, and four out of five patients are diagnosed only after it has spread. Patients usually have no symptoms until the cancer has spread to other organs. While surgery to remove the tumor or entire organ can cure up to 50 percent of early-stage pancreatic cancer, doctors see few patients in that stage.

“It’s almost invariably advanced,” said Dr. Kirk Heyne, a medical oncologist at the Houston Methodist cancer center who was not involved in the study. “Probably 15 percent of people can be taken to surgery.”

‘Unheard of’ accuracy

Even after diagnosis, there are no good ways of tracking what is happening with the cancer. Patients must undergo repeated biopsies or CT scans to determine whether the treatment is working or whether their cancer has progressed or recurred.

Researchers found the marker by looking at exosomes, tiny bundles containing DNA and other genetic material, released by the body’s internal cells.

They compared exosomes from healthy and cancerous cells and found the cancer exosomes contained a particular protein. By searching for exosomes with this protein in the bloodstream, the researchers could detect and quantify the amount of cancer in the body.

They then screened the blood of hundreds of pancreatic cancer patients, diagnosed at different stages, and hundreds of healthy donors for exosomes containing the protein. In addition to M.D. Anderson, institutions in Germany and Spain participated in the study.

“When it was positive for it, it was always in the cancer patients,” Kalluri said, “never in the hundreds of healthy subjects or those who didn’t have pancreatic cancer. The fine difference with which it was able to distinguish is unheard of in the cancer field.”

The test had zero false positive and zero false negative results.

Moreover, the study found the more advanced the patient’s cancer, the more exosomes in their blood, and when tumors were removed with surgery, levels of the exosomes dropped.

Pancreatic cancer experts called the study promising and were eager to see if further research would confirm the accuracy of the test.

“Blood-based biomarker studies for pancreatic cancer have been somewhat disappointing overall,” said Dr. Michael Goggins, director of the Pancreatic Cancer Early Detection Laboratory at Johns Hopkins University. “This one has some promising characteristics.”

The test could be used primarily in patients at higher risk for pancreatic cancer, such as those who are obese, diabetics, smokers or those with a family history of the disease.

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Blood Test Could Potentially Diagnose Pancreatic Cancer Early

Due to the lack of reliable early detection methods, the vast majority of pancreatic cancer cases are diagnosed once the disease has spread locally or widely throughout the body. Patients whose disease is diagnosed when it’s still confined in the pancreas have the best chance for long-term survival, which is why improved early detection strategies are urgently needed for pancreatic cancer.

A paper, entitled “Glypican-1 identifies cancer exosomes and detects early pancreatic cancer,” was published online in the prestigious journal Nature on June 24, 2015, and describes a promising, potential pancreatic cancer early detection biomarker. A biomarker is a molecular clue inside the body that can be detected and measured, providing useful information.

The paper reports that pancreatic cancer cells emit small particles called exosomes, which contain DNA and proteins. Unexpectedly, the research team from MD Anderson and abroad found that pancreatic cancer-derived exosomes contain significant levels of a protein called glypican-1 (GPC1), which is detectable at much higher levels in blood samples from pancreatic cancer patients, compared to healthy individuals. Even people with other pancreatic diseases, like chronic pancreatitis, had levels of GPC1 similar to healthy individuals, suggesting that its presence may be specific to cancer. Moreover, higher levels of GPC1-positive exosomes were found in every pancreatic cancer patient that was evaluated. By contrast, GPC1-positive exosomes were detectable in some, but not all, breast cancer samples analyzed.

In addition to blood samples from patients with advanced pancreatic cancer, the research team analyzed samples from five individuals with confirmed precancerous abnormalities in their pancreas. Encouragingly, these samples were distinguishable from healthy control individuals, suggesting that this method of detecting and measuring GPC1-positive exosomes in blood samples holds promise for the earlier detection of pancreatic cancer.

It is important to note that these results, while promising, are preliminary and have not been verified in a prospective, or forward-looking, study. More research will be necessary to determine whether the authors’ results can be confirmed as well as whether and how detection of GPC1-positive exosomes could be standardized for use in a clinical setting, rather than in a laboratory.

For more information about this article, please refer to the press release issued by the University of Texas MD Anderson Cancer Center.

For information about pancreatic cancer diagnosis, treatment and other patient services, please call 877-272-6226, Monday – Friday, 7 a.m. – 5 p.m. PT, or email a Patient Central Associate at

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Breast cancer surgeon, 55, dies just one month after being diagnosed w/ Pancreatic Cancer

A sad, unfortunate example of how deadly pancreatic cancer truly is:

Leading breast cancer surgeon, 55, dies just a month after being diagnosed with pancreatic cancer


Tributes have poured in for one of North Carolina’s leading breast cancer surgeons who passed away from cancer at the weekend – just 33 days after she was diagnosed.

Dr. Teresa Flippo-Morton, 55, succumbed to the disease on Sunday, little over a month since she learned she had pancreatic cancer that had spread to her liver.

Former colleagues and patients – some of whom credit her with saving their lives – have paid tribute to the skilled surgeon and married mother on a Caring Bridge page she set up after her diagnosis.

She treated an estimated 2,300 women with breast cancer after completing her training in 1991, Dr. Richard White, a friend and colleague at the Levine Cancer Institute, told the Charlotte Observer.

‘This is a massive loss for our community,’ he told the newspaper. ‘She was loved by her patients. She was loved by her peers. She was loved by her students.’

The West Virginia-native, who worked at the Levine Cancer Institute, started feeling abdominal and back pain at the end of April and a scan revealed a mass on her pancreas on May 5. Further tests showed that it had spread to her liver.

She took a previously planned trip to the United Kingdom before she returned and started chemotherapy on May 21.

Following the diagnosis, she set up a Caring Bridge page to keep loved ones updated with her treatment. The page has now been visited nearly 20,000 times.

She thanked her family and friends for her support as she started her treatment.

‘I am completely moved by the cards,letters, texts, emails, and posts to this site!’ she wrote from hospital on May 20. ‘I felt immediately the warm all-encompassing love and support from everyone.’

Others took to the page to express their thanks to her.

‘You have touched the lives of so many people in so many ways as you learned and then practiced your calling,’ wrote Lee Ann McGinnis on May 31. ‘Your openness and honesty this past month is a reflection of the integrity with which you have always lived your life. You are a blessing to us.’

Another added: ‘You are the most compassionate and gracious doctor that I have ever met. You have truly touched so many lives for the better, as you have touched mine.’

On May 24, Dr. Patrick Connor, a fellow surgeon who first met Flippo 25 years ago while he was on his residency, expressed his shock and sadness at her diagnosis.

‘It is so difficult to get one’s arms around how someone so kind, caring and smart who has spent her entire professional life dedicated to the treatment and care of patients with cancer is now fighting the battle from a different perspective,’ he wrote.

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Treatment Doubles Progression-free Survival in some PanCan Patients

Enzyme lowers pressure inside tumors, allows chemotherapy in

Combining chemotherapy with an experimental enzyme that lowers pressure within tumors seems to double the amount of time certain patients with metastatic pancreatic cancer have before their disease progresses, suggests an interim analysis of data from an ongoing phase 2 trial. However, the trial must be completed before any definitive conclusions can be drawn, cautioned study principal investigator and pancreatic cancer expert Dr. Sunil Hingorani of Fred Hutchinson Cancer Research Center.

“For me, this ― at an absolute minimum ― says ‘finish this trial,’” said Hingorani, who is presenting the interim results of the Halozyme Therapeutics-sponsored Halo 202 trial this Sunday at the annual meeting of the American Society for Clinical Oncology. The meeting, which begins today in Chicago, runs through June 2.

The trial combines the latest first-line, standard-of-care combination chemotherapy for advanced pancreatic cancer with an enzyme called PEGPH20 that breaks down hyaluronic acid, or HA. HA is a molecule that absorbs water and serves as a natural shock absorber in knee joints. But it’s also produced in high amounts in some tumors and has been linked to a poor prognosis.

In high-HA tumors, the water-loving HA sucks the moisture from surrounding tissues into the tumor, leading to such high pressures that drugs travelling through the bloodstream can’t get in to effectively attack cancer cells.

PEGPH20 is a version of the naturally occurring hyaluronidase enzyme that breaks down HA, which has been modified to be more stable in the body. The idea behind the trial, generated by mouse model research published in 2012 by Hingorani’s team, is that using the enzyme to break down HA and lower the pressure inside the tumors will allow blood to penetrate and deliver cancer-killing drugs to their targets.

Last September, the U.S. Food and Drug Administration granted fast-track status to Halozyme’s PEGPH20 program in pancreatic cancer, a designation that is designed to speed the development and review of drugs that fill an unmet need in treating serious medical conditions.

On Sunday, Hingorani will present results from 135 participants in the trial. So far, these preliminary data show that of the patients with high-HA tumors, those who received the experimental enzyme with their chemo experienced an average of 9.2 months of progression-free survival, more than double the 4.3 months of those with high HA who were treated with chemo but no enzyme. (For the patients with low HA, the enzyme didn’t seem to make a difference; these patients had only around five months of progression-free survival, on average, regardless of whether they had received the enzyme.)

The progression-free survival conferred on the high-HA patients by the experimental treatment is higher than the overall survival (a much more definitive survival measure) seen in a recently completed phase 3 trial of the combination chemotherapy — “which is what makes this so surprising,” Hingorani said.

Halozyme Therapeutics presented these preliminary results to analysts and investors in January. Reuters reported that CEO Helen Torley said PEGPH20 is “a blockbuster in waiting” and cited the wide range of solid tumors known to produce high levels of HA. Halozyme plans to begin a phase 3 trial of PEGPH20 in patients with high-HA pancreatic tumors early next year.

Halo 202’s preliminary results hold out the prospect of doubling the remaining life spans of many patients with metastatic pancreatic cancer, a disease in which survival after diagnosis is measured in months. But Hingorani stressed that these are still small numbers of patients and the results are still preliminary. “I look at this and I say, ‘OK, the hypothesis is still intact,’” said Hingorani, who has no personal financial interest in the study and said he has never owned any of Halozyme’s stock.

But he’s hopeful.

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