Monthly Archives: November 2015

Researchers Focusing on Early Detection, Immunotherapy for Pancreatic Cancer

The challenge with pancreatic cancer has always been to catch it early. Because of its subtle, variable symptoms, the disease often isn’t diagnosed until an advanced stage, when it is particularly difficult to treat.

Researchers are investigating not only how to detect the disease earlier but also how to better understand its causes and develop more effective treatments.

Pancreatic cancer arises in a series of steps that occur over a number of years. At the earliest stages, pancreas cells begin to acquire mutations or other abnormalities in a small number of genes. As abnormalities arise in additional genes, the cells of the pancreas begin to look abnormal. One of the most common genes to be affected is KRAS, which regulates cell growth. Researchers are developing new diagnostic tests that can detect this change using fluid extracted from the pancreas, although such tests aren’t yet ready for general use.

In recent research, scientists at Dana-Farber and other institutions recently found that an upsurge in certain amino acids often occurs before pancreatic cancer is diagnosed and symptoms appear. Although the increase isn’t large enough to be the basis of an early-detection test, the discovery will help researchers better understand how pancreatic cancer affects the rest of the body, particularly how it can trigger the sometimes deadly muscle-wasting disease known as cachexia.

Efforts to improve the treatment of pancreatic cancer include the development of new surgical and radiation therapy techniques, new combinations of chemotherapy drugs, targeted therapies, and therapies that harness the immune system to attack the disease.

In the surgical field, investigators are exploring whether laparoscopic procedures – which involve inserting surgical instruments through small cuts in the abdomen – to remove cancerous pancreatic tissue are as effective as traditional, large-incision techniques and whether they improve the recovery process. Some studies are also examining whether delivering a large dose of radiation therapy to the pancreas during surgery is beneficial.

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*credit verbatim via Dana-Farber Cancer Institute*

Only 1 in 5 US #PanCan patients get key blood test at diagnosis

Study: Only 1 in 5 US pancreatic cancer patients get this key blood test at diagnosis

CA 19-9 tumor marker test especially important for early-stage patients, Mayo finds

NAPA, Calif. — Only 1 in 5 U.S. pancreatic cancer patients receive a widely available, inexpensive blood test at diagnosis that can help predict whether they are likely to have a better or worse outcome than average and guide treatment accordingly, a Mayo Clinic study shows. People who test positive for elevated levels of a particular tumor marker tend to do worse than others, but if they are candidates for surgery and have chemotherapy before their operations, this personalized treatment sequence eliminates the elevated biomarker’s negative effect, researchers found.

The findings will be presented at the Western Surgical Association annual meeting Nov. 7-10 in Napa.

“This is another argument for giving chemotherapy before surgery in all pancreatic cancer patients and ending the old practice of surgery followed by chemo,” says senior author Mark Truty, M.D., a gastrointestinal surgical oncologist at Mayo Clinic in Rochester, Minn. “The study answers an important clinical question and applies to every pancreatic cancer patient being considered for surgery.”

The Mayo study, which used the National Cancer Data Base, is the first on the subject based on national data and is the largest of its kind, Dr. Truty says.

Researchers analyzed outcomes for 97,000 patients. The tumor marker whose impact they studied is known as CA 19-9. It is associated with several cancers, including pancreatic cancer, and can be measured in the blood of most people: 10 percent do not produce it. Pancreatic cancer patients who didn’t secrete CA 19-9 were also studied.

Pancreatic cancer patients whose blood showed higher-than-normal CA 19-9 levels tended to have worse outcomes than others at the same stage of cancer, the study found. Surprisingly, the elevated tumor marker’s negative effect on survival was most pronounced in patients diagnosed at an early stage, the researchers wrote.

“When we looked at how these patients did after surgical removal of their cancers, the only treatment sequence that completely eliminated the increased risk posed by CA 19-9 elevation was chemotherapy followed by surgical removal of the tumor,” Dr. Truty says.

Another key finding was that only 19 percent of pancreatic cancer patients nationally have their CA 19-9 checked at diagnosis, far fewer than anticipated, he says. The CA 19-9 blood test has been standard for pancreatic cancer patients at Mayo Clinic for years.

Failing to test for and address elevated CA 19-9 means that many patients with above-normal levels may undergo significant surgeries that may not be as beneficial long term as anticipated, Dr. Truty says.

About 50,000 people are diagnosed with pancreatic cancer each year in the U.S. Historically, only about 7 percent of pancreatic cancer patients have lived at least five years after diagnosis. But advances such as the CA 19-9 test and improved chemotherapy, radiation and surgical techniques are improving survival odds for many patients, Dr. Truty says.

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