The Dream Team opens clinical trial to find better treatment options for pancreatic cancer

A new team of pioneering pancreatic cancer researchers has been formed to predict which treatments might work best for individual pancreatic cancer patients based on the molecular traits of tumors. The Pancreatic Cancer Convergence Dream Team is funded by the Pancreatic Cancer Collective, an initiative of the Lustgarten Foundation and Stand Up To Cancer® (SU2C), SU2C Canada and Pancreatic Cancer Canada.

The team will be led by Jennifer Knox, MD, the Lewitt Chair in Pancreatic Cancer Research at the Princess Margaret Cancer Centre, part of University Health Network, and professor of medicine at the University of Toronto in Canada, and Elizabeth Jaffee, MD, a professor of oncology and deputy director of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins in Baltimore, Maryland.

This team's cutting-edge work to better understand the makeup of pancreatic cancers will benefit tens of thousands of cancer patients in the United States and around the world. Pancreatic Cancer Collective-supported research has already contributed to a 2013 FDA approval of a combination therapy for advanced pancreatic cancer; the work of this Dream Team is an important next step in determining if that treatment, or another leading treatment, will work best for different pancreatic cancer subtypes."

Nobel Laureate Phillip A. Sharp, PhD, Chair, SU2C Scientific Advisory Committee, Co-Chair, SU2C Canada Scientific Advisory Committee and Institute Professor, David H. Koch Institute for Integrative Cancer Research at Massachusetts Institute of Technology

Pancreatic cancer is the third leading cause of cancer-related death in both the United States and Canada and is exceptionally difficult to treat. The five-year survival rate for pancreatic cancer is around 10% in the United States and 8% in Canada. Additionally, Black people in the U.S. and Canada are more likely to develop pancreatic cancer than whites. In the U.S., the incidence of pancreatic cancer is 19% higher in Black men compared to white men, and 36% higher in Black women compared to white women. The Dream Team hopes to address this disparity by making recruitment of diverse patients a top priority in their research.

The Dream Team recently opened a phase II clinical trial entitled Pancreatic Adenocarcinoma Signature Stratification for Treatment (PASS-01) Trial looking more closely at the two leading treatments for advanced pancreatic cancer. One of those treatments is Modified FOLFIRINOX, which is a combination of four chemotherapy drugs. The other treatment is a combination of chemotherapy drugs gemcitabine and nab-paclitaxel. The U.S. Food and Drug Administration approved that treatment in 2013 based, in part, on the work of a previous SU2C Pancreatic Dream Team, which was a part of the Pancreatic Cancer Collective portfolio.

The two treatments are helpful for some pancreatic cancer patients but have little effect for other patients. The goal of the PASS-01 trial is to uncover more about how the two treatments work. Currently, precision medicine for pancreatic cancer patients includes a comprehensive evaluation of the tumor's genomic profile. But, doctors still don't know enough about the different types of pancreatic cancer to determine whether either treatment will help an individual patient, and if so, which treatment might work best. Building on the findings from a pancreatic cancer clinical trial conducted by the Ontario Institute for Cancer Research--which also is a collaborator on the PASS-01 trial--potential predictors of patient response to chemotherapy will be further tested by Knox and Jaffee and their Dream Team colleagues. They also hope the trial will help them learn more about biomarkers within patients' tumors. Their goal is to be able to identify specific biomarkers that indicate whether a pancreatic cancer will respond better to one treatment versus the other.

At the same time, the clinical trial will explore another promising method in fighting pancreatic cancer by uncovering the unique characteristics of individual patients' tumors. Collaborators at Cold Spring Harbor Laboratory in Cold Spring, New York, will create patient-derived organoids (PDOs) from biopsies of trial participants' tumors. The miniature 3-D structures are grown in lab dishes from tiny bits of tumors taken from patients. Scientists then see how the PDOs react to different types of cancer drugs. This work may lead to more effective individualized treatments for pancreatic cancer.

"We have brought together some of the finest pancreatic cancer researchers in North America; the time is right to dig in much deeper to help understand pancreatic cancer," Knox said. "We need to stop assuming one size fits all and instead advance the field by gaining a better understanding of every tumor. We believe our work can help doctors treat patients optimally today while providing a better understanding of this deadly disease into the near future."

"There is a critical need to identify ways that medicine can better treat pancreatic cancers," Jaffee said. "We believe by identifying and learning more about these biomarkers, we can help make that happen. We can give patients more hope that their cancers can be treated effectively."

"Personalized medicine has been a game changer in the treatment of many other cancers and this trial is a significant step toward offering this type of individualized care to metastatic pancreatic cancer patients," said David Tuveson, MD, PhD, chief scientist for the Lustgarten Foundation and director of the Lustgarten Foundation Pancreatic Cancer Research Lab at Cold Spring Harbor Laboratory where pancreatic cancer organoids were co-developed. "The international partnership between these organizations is a great example of collaboration between labs to help physicians make faster, better informed decisions in efforts to provide patients with better outcomes."

Knox and Jaffee have already begun enrolling clinical trial participants at Princess Margaret Cancer Centre and Johns Hopkins. The team hopes to enroll 150 patients in the trial, with four additional locations throughout the United States and Canada opening soon, including Memorial Sloan Kettering Cancer Center in New York City, Northwell Health in Long Island, Dana Farber Cancer Institute in Boston and BC Cancer in Vancouver, B.C.

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