New ‘playbook’ describes how disease is driven by a complex network of factors, suggesting that combination-based treatments may be more successful in improving survival rates
Progress on treating pancreatic cancer will depend on smarter, combination-based treatments that target multiple areas, the authors of a new ‘playbook’ on the disease have said.
Researchers at the Trinity St James’s Cancer Institute (TSJCI) have published a major new review on pancreatic cancer, a disease with a five-year survival rate of just 13 per cent.
Rather than treating pancreatic cancer as a single problem, the paper describes how it is driven by a complex network of factors, including: genetic mutations, the tumour microenvironment, immune system evasion, metabolic changes, tumour-nerve interactions, and even the microbiome.
By integrating the findings from hundreds of studies across these multiple areas, the review highlights how these processes work together, not in isolation, to make pancreatic cancer so difficult to treat.
As a result, authors believe that single-drug approaches to treating the disease are unlikely to succeed. Instead, they argue that progress will depend on smarter, combination-based treatments that target multiple hallmarks of the disease at once. This shift in thinking could have important implications for how clinical trials are designed and how new therapies are developed.
“Despite decades of research, outcomes for pancreatic cancer patients have improved only marginally,” said senior author Stephen Maher, Professor in Translational Oncology.
“This paper helps explain why. It also provides a road map for designing the next generation of treatments, ones that reflect the true complexity of the disease.”
Pancreatic cancer has the worst survival rate of any major cancer. Late detection, aggressive tumour biology, limited treatment options and a lack of research funding has meant progress has been frustratingly slow.
By publishing a comprehensive ‘playbook’ of the disease, Trinity researchers are highlighting how multiple biological systems interact to drive its growth, which they hope will inspire new research into the cancer.
The comprehensive review applies the most up-to-date ‘Hallmarks of Cancer’ framework (a globally recognised generic model describing the essential traits of cancer, first developed in 2000 by Douglas Hanahan and Robert Weinberg) to pancreatic cancer, in unprecedented detail.
By integrating the findings from hundreds of studies across these multiple areas, the review highlights how these processes work together, not in isolation, to make pancreatic cancer so difficult to treat.
“Pancreatic cancer is not driven by one pathway, it’s a highly coordinated system,” said lead author Dr Laura Kane.
“What we’ve done is bring all of that complexity together into a single, usable framework. By showing how these different mechanisms connect, we can start to see where the real vulnerabilities of the disease may lie.”
Read the study: The Hallmarks of Pancreatic Cancer – Cancer Letters
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