Can pancreatic cancer be stopped in its tracks? Radical tactic raises hopes

Armed with new tools and new optimism, researchers seeking to beat pancreatic cancer — one of the deadliest in the world — are pursuing a radical strategy: cancer interception.

In this approach, tissue that is growing abnormally is treated to prevent it from becoming cancerous and spreading. Interception is already being tested for breast and skin cancers, among others. But now the success of a new drug that can kill pancreatic tumors is raising scientists’ hopes that interception could be successful, even for this stubborn cancer.

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Stopping cancer was a major theme at last week’s American Association for Cancer Research (AACR) conference on pancreatic cancer in San Diego, California – the first such meeting since the U.S. Food and Drug Administration approved the landmark pancreatic cancer drug daraxonrasib (Rasonque) in August. Its success has renewed optimism that researchers can combine it, or other emerging therapies, with early detection methods to revolutionize the way pancreatic tumors are treated.

A combination of early detection and interception techniques “is going to be the breakthrough strategy that really changes survival,” says Diane Simeone, director of the Moores Cancer Center at University of California San Diego Health. At the AACR meeting, Simeone argued that such an approach could more than triple the proportion of people who survive five years after being diagnosed with pancreatic cancer, from 13.7% to 50%.

It’s a noble aspiration, but other researchers are also considering interception. “We’re so happy to be at this point to be considering this,” says Anirban Maitra, director of the Perlmutter Cancer Center at NYU Langone Health in New York. “This was not possible just a few years ago.”

Precautionary principle

Pancreatic tumors are notoriously tricky: They are often highly invasive, impervious to most treatments, and can wrap around major arteries and veins, making the growths difficult to remove.

Still, five-year survival rates can exceed 80% when these tumors are detected early, Simeone says. But the symptoms of pancreatic cancer are vague, and people often don’t seek medical attention right away. More than half of pancreatic cancers are diagnosed only after the disease has spread to other organs – a statistic that has remained virtually unchanged since Simeone opened his cancer research laboratory 30 years ago.

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To improve early detection, she and her colleagues launched a clinical study called PRECEDE, which aims to recruit 20,000 people with a family history of pancreatic cancer, certain abnormal pancreatic tumors, or a genetic profile that increases their risk of developing the disease. The goal is to see if – and to what extent – ​​frequent surveillance for pancreatic cancer will improve survival. So far, the team has recruited just over 12,000 people, Simeone said at the conference. More than 50 participants were diagnosed with pancreatic cancer, many in the early stages of the disease.¹.

The PRECEDE team plans to use samples from the study to evaluate experimental blood tests for early cancer detection and explore artificial intelligence methods to detect abnormalities on participants’ scans before they become visible to the naked eye.

Additionally, Simeone says the PRECEDE consortium could test whether therapies such as daraxonrasib can increase survival rates when given immediately after surgery to remove precancerous growths or tumors at an early stage. Currently, daraxonrasib is only approved for advanced cancers.

Tolerance test

Researchers at the AACR meeting heard about studies in mice suggesting this approach might work. Ben Stanger, a cancer researcher at the University of Pennsylvania in Philadelphia, and his team studied mice carrying mutations in a gene called Kras; These mutations produce proteins that can cause cancer. When the mice developed tiny precancerous pancreatic growths, the researchers administered a drug that, like daraxonrasib, disarms KRAS and related cancer-promoting proteins. Treatment improved animal survival². “It’s super exciting,” Stanger says, but adds that it may take years to determine how best to deploy the technique in people.