Pancreatic cancer is one of the deadliest cancers. Even with aggressive treatment, the prognosis is poor, with various factors stacking the odds against successful treatment: early detection is uncommon, it tends to spread quickly and recurrence is likely. However, several newer approaches show promise in increasing the response rate to pancreatic cancer treatment. A recent randomized clinical study involving pancreatic cancer patients is now shedding light on a fascinating potential approach to more personalized care for this form of cancer. And it's all due to a gene called KRAS, which appears in humans in several varieties, some of which are responsible for causing cancerous cells.
The study was sponsored by the U.S. National Cancer Institute through a clinical trials agreement between the Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, and Oncolytics Biotech, Inc. a Calgary-based biotech focused on the development of oncolytic viruses as potential therapeutics for use in a broad range of cancers.
Oncolytics' lead product is REOLYSIN®, a proprietary formulation of the human reovirus. Oncolytics is conducting clinical studies using REOLYSIN to combat some of the most deadly cancers, including lung, colorectal and pancreatic cancers. Oncolytics' clinical program encompasses a number of human trials at a variety of stages, and data to date demonstrate REOLYSIN might be a safe and effective treatment option, but other studies are needed.
Previous research determined that REOLYSIN is most effective in cancer cells with a feature called an activated RAS pathway. Those with "mutant KRAS" (m-KRAS) tumors have RAS-activated tumors; those with "wild-type KRAS" (wt-KRAS) may not. This was designed to be the first randomized clinical study to directly measure the effect of KRAS mutations in response to REOLYSIN. Oncolytics was not surprised at the result: those patients in the clinical trial with mutant KRAS did, indeed, exhibit a better response to treatment with REOLYSIN than those with wild-type KRAS.
In addition to corroborating our understanding of the relationship between KRAS type and response to REOLYSIN, the study offers a clue toward more personalized care. In the future, patients interested in treatment with the human reovirus should first be screened to see if they carry the mutant KRAS gene. Oncolytics believes that as many as 65 to 70 percent of people carry this type, whereas those with wild-type KRAS appear to be less likely to benefit from it.
By using the presence of mutant KRAS as a biomarker, Oncolytics and other companies developing treatments for pancreatic and other cancers might be able to personalize treatment, and hold out the possibility of better outcomes for treating this terrible disease.