CONTACT US
Pancreatic cancer stands apart as a difficult disease to prevent, diagnose and treat. Of all the major cancers, it is the only one with a five-year survival rate that still hovers below 20 percent.
But change may be on the horizon.
PanCAN Chief Science Officer, Lynn Matrisian, PhD, MBA, and Chief Scientific and Medical Officer, Anna Berkenblit, MD, MMSc, are optimistic that a new wave of precision medicine breakthroughs may bring progress to pancreatic cancer that other types of cancer have seen over the past several decades.
Here, Dr. Matrisian and Dr. Berkenblit talk about what may be next and the work that needs to be done to ensure ALL patients with pancreatic cancer benefit from this progress.
Let’s start with the basics to lay the foundation for our discussion. What is precision medicine?
Lynn: Precision medicine is treatment based on a person and their tumor’s biology. The goal is to identify specific treatments that may be more beneficial for a specific patient, essentially targeting the cancer while minimizing harm to healthy cells. This can be done through genetic testing for inherited mutations and tumor biomarker testing.
Biomarker testing of tumor tissue reveals the tumor’s biology, such as genes and proteins within the tumor. Genetic testing for inherited mutations shows mutations a person is born with. This information about molecular alterations can help doctors identify precision medicine treatments, which can include targeted therapies, immunotherapies, chemotherapies and more.
Many major hospitals and cancer centers now offer biomarker and genetic testing. PanCAN also provides it through our Know Your Tumor® precision medicine service.
You both have expressed optimism about the promise of precision medicine for pancreatic cancer. What potential impact do you see?
Anna: There are exciting new drugs being tested that target mutant KRAS, which was long thought to be “undruggable.” Almost all pancreatic tumors have some alteration in the KRAS gene, greatly expanding the number of pancreatic cancer patients who could benefit from a targeted therapy. This may not only provide patients with the opportunity for a highly effective treatment but may also increase the number of patients who have their tumor tested for molecular alterations, making precision medicine a standard approach for pancreatic cancer. This would be a major advance for science and a major advance for patients with pancreatic cancer!
Lynn: I second Anna’s enthusiasm – we are optimistic about the progress being made in this area of research. For a long time, pancreatic cancer has lagged behind other types of cancer when it comes to effective targeted therapies. Right now, about one out of every four pancreatic cancer patients is a candidate for a targeted therapy. Physicians haven’t always recognized the value of biomarker testing early enough to incorporate this possibility into the treatment plan. But with the treatments currently in development, we hope to see this change.
Why is it critical that all patients, including those in underserved communities and rural areas, have access to biomarker and genetic testing?
Anna: We need to make sure every patient with pancreatic cancer can take advantage of the advances in precision medicine. This is especially important as we look to the next five to 10 years, when we expect more treatments targeting KRAS to become available. Unfortunately, right now, we see disparities in access to biomarker and genetic testing. Patients in rural areas and patients from underserved communities are less likely to have testing recommended to them. They are also less likely to undergo testing. Insurance plays a role here, as does access to resources.
Lynn: This is so important because we already see disparities in survival based on insurance status, socioeconomic status, race and ethnicity. There’s the potential for these disparities to widen unless we make sure biomarker and genetic testing is available to everyone who needs it.
How is PanCAN working to address some of these barriers to biomarker and genetic testing?
Lynn: Like so much of healthcare, it’s complicated, but PanCAN is part of the solution. Our Know Your Tumor precision medicine service has been offering free biomarker and genetic testing to patients since 2014 – long before widespread recognition of its value. Our commitment has always been to make sure ALL patients with pancreatic cancer can thrive. This means we continue to focus on connecting patients with Know Your Tumor and PanCAN Patient Services.
Anna: And I’ll add: We also need to raise awareness with healthcare providers, lawmakers, policy makers and others about the critical importance of access to biomarker and genetic testing for pancreatic cancer patients, so that we don’t see these disparities widen.
Patients and their family members – what would you like them to know about biomarker and genetic testing?
Anna: Biomarker and genetic testing are so important! PanCAN strongly recommends all pancreatic cancer patients get genetic testing for inherited mutations as soon as possible after diagnosis and biomarker testing of their tumor tissue to help determine the best treatment options. Genetic testing for inherited mutations can also inform family members of risk regardless of family history.
Advocate for yourself and your loved ones, seek out a healthcare team you trust, ask questions and get in touch with PanCAN Patient Services for support.
And what about healthcare professionals – what would you like them to know about biomarker and genetic testing?
Lynn: We know that patients with pancreatic cancer benefit from genetic and biomarker testing. PanCAN led the way here – Know Your Tumor has contributed valuable information. For example, based on data from Know Your Tumor, we now know that patients with DNA damage repair alterations in their tumor respond better to platinum-based chemotherapy. For these patients, this means improved survival and quality of life. And our 2020 Lancet Oncology paper showed that patients who receive a matched therapy live an average of one year longer than those who don’t. One year! For patients and families, this additional time means everything.
So to our healthcare professional colleagues: It’s critical that every patient with pancreatic cancer has biomarker testing and genetic testing as soon as possible after diagnosis. Consider PanCAN your partner. Refer your patients to PanCAN for support and for access to services like Know Your Tumor.
