What’s New in Pancreatic Cancer Research?

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2013- Focus on Pancreatic Cancer Conference. In this blog, she discusses new advancements in pancreatic cancer research.

Chi Van Dang, MD, PhD, at the 2nd FO Pancreatic Cancer

Starving Pancreatic Cancers

What do pancreatic cancers require to “feed” themselves? How can that information be used to design new treatments for this disease? Greg Beatty, MD, PhD, noted at the 2nd Focus On Pancreatic Cancer Conference that different approaches to imaging are increasingly being used to understand the tumor’s biology. Today, imaging encompasses much more than the standard x-ray or cat scan can provide. Novel imaging modalities allow doctors to understand not just the way tissue looks, but also how it functions and behaves—with significant implications for new approaches to treating cancer.

One such new approach, using FDG-PET, involves looking at metabolic images. Pancreatic cancers require large amounts of glucose—a kind of sugar—in order to grow. Creating visual images of which cells are taking up large amounts of these sugars makes it possible not only to identify cancers, but potentially to find them earlier and to distinguish primary cancers from metastatic disease, as well as providing a useful method of determining if a treatment is working in as little as two weeks from the beginning of treatment. Understanding the metabolism of pancreatic cancer opens the possibility of developing targeted treatments that deprive these tumors of the nutrients they need, in effect starving them to death—work that is already underway at Penn and other research centers.

Improving the Neighborhood

Better understanding of the biology of pancreatic cancers is also one key to another novel approach to treating this disease. Researchers now know that the neighborhood in which the pancreatic cancer exists plays a critical role in helping the tumor to grow.

“Pancreatic cancers form islands of tumor cells surrounded by a sea of what is known as stromal tissue,” says Dr. Beatty. “In animal models, we have seen that this stromal tissue in some ways isolates the tumor. The chemotherapy that we deliver though the blood vessels ends up being far from the cancer cells themselves, and being delivered to the stromal tissue. So the drugs have a hard time getting to the cancer cells. If we can break down the stroma, we can improve the efficiency of our current therapies.”

Better Education for the Immune System

Researchers have known for years that pancreatic cancer somehow co-opts the immune system, educating our natural defenses to help the tumor grow and spread. Now, with what Dr. Beatty describes as an “exponential increase in knowledge about the role of the immune system in pancreatic cancer,” the potential exists for “re-educating” out immune cells to fight the cancer. The neighborhood, or stroma, plays a key role in this approach as well. To use a different analogy, our tissue is like a wall, with the cancer being the bricks and the stroma being the mortar or supporting structure. If you can attack that supporting structure, you can break down the wall—and destroy the tumor.

One new approach uses an antibody known as CD40 to activate the immune system, turning on cells called macrophages to attack and kill cancer cells, and to eat away at the stroma. Another new treatment utilizes specially engineered cells taken from the patient’s own body to activate T-cells to kill cancer cells. Both of these efforts to provide good education to our immune cells are the basis for clinical trials now underway at Penn.