The International Cancer Genome Consortium team have created the most accurate road map of pancreatic cancer to date. The genome of 462 tumors taken from pancreatic cancer patients was deeply sequenced. In these tumors, researchers identified a recurring set of 32 genes whose mutations, through one of ten molecular pathways, spurned cancer growth. From there, the the tumors were broadly classified into four subtypes, each with a distinct pattern of mutations, gene expressions, and even outward characteristics. The four subtypes identified should provide a basis to offer new insights into personalised therapeutic options for individual patients and a launch pad to investigate new treatments.

The subtypes are:

• Squamous, containing tumors resembling those found elsewhere in breast, bladder, lung, and head and neck cancer;
• Pancreatic progenitor, involving genes known to be linked with the early development of the pancreas in embryos;
• Aberrantly differentiated endocrine eXocrine (ADEX), a subclass of the second, involving genetic processes that help govern the later stages of the organ’s development;
• Immunogenic, another type similar to pancreatic progenitor but which provokes an unique immune response compared to the rest.

In particular, the discovery of pancreatic immunogenic tumors may hold the best promise for further research. In fact, this subtype of pancreatic cancer is characterised by specific mechanisms that can potentially be targeted using immune modulators.

The findings of this research, published in Nature, are incredibly exciting for anyone affected by pancreatic cancer, as they should mean that in the future the right patients can be given the right treatment at the right time. This is crucial, because the disease is difficult to diagnose, and is often diagnosed terribly late.

Profound as these findings may be, it should be noted that the study specifically examined pancreatic ductal adenocarcinomas, which comprise most (90 perecent) but not all pancreatic cancer cases. The researchers note that pancreatic cancer is currently the fourth leading cause of cancer death in the Western world, and is projected to be the second leading within a decade, though this is partly because it’s expected that cancer survival rates elsewhere will continue to increase.

Professors Andrew Biankin and Sean Grimmond, laboratory heads at Sydney’s Garvan Institute of Medical Research and the University of Queensland’s Institute for Molecular Bioscience (IMB) respectively, led the study. Both are now based at the Wolfson Wohl Cancer Research Centre, part of the University of Glasgow in Scotland. The Verona group was led by Professor Aldo Scarpa (ARC-NET Cancer Research Center), Professors Claudio Bassi and Roberto Salvia (Pancreatic Surgery), and by Professor Giampaolo Tortora (Medical Oncology).

To see the abstract on the publisher’s website click here.