Study shows potential for personalized approach to cancer treatment
A three-drug combination can simultaneously target the cancerous and other harmful cells within a pancreatic tumor to improve survival, a new study from the Wilmot Cancer Institute shows. This could potentially offer a personalized approach to treating pancreatic cancer.
The research builds on previous scientific data from the lab of David. Linehan, M.D. Ultimately, physicians will use information from the pancreas tumor biopsy about volume and predominance of cancer cells and non-cancerous inflammatory cells that impact the immune system, and then plan the best treatment.
“People with pancreatic cancer don’t have 10 years to wait for the next new drug,” said Linehan, a surgical oncologist, director of clinical operations at Wilmot, and the Seymour I. Schwartz Professor and Chair of the Department of Surgery at the University of Rochester Medical Center.
“Our approach is based on evidence that this disease has particular characteristics involving both the tumor and the immune response,” he said, “and we believe that treatment must address all sides of the problem.”
More than 80 percent of a pancreatic tumor is made of cells that are non-malignant cells. But many of these non-cancer cells, called tumor-associated macrophages, still play a vital role in promoting cancer by preventing the immune system from attacking the cancer. In addition to TAMs, pancreatic tumors have tumor-associated neutrophils that further block the immune system when pancreas cancer is present. Patients who have a high number of TAMs and TANs in their biopsy samples have a poorer prognosis. Given the fact that pancreatic cancer is mostly incurable and the incidence is rising, there is an urgent need for improvements in treatment through research.
The objective of Linehan’s study was to target TAM and TAN with a combination of experimental drugs that would reduce their numbers and allow the body’s own immune defenses to act appropriately and fight the cancer, and to boost the effectiveness of standard chemotherapy. The study was conducted in mice but researchers also performed correlative analyses on human pancreatic tumor samples. Results showed that targeting TAM and TAN—as well as the cancer cells—improved anti-tumor immunity and chemotherapy response better than using any single therapy.
Linehan began this investigation at Washington University. Since joining the URMC and Wilmot in 2014, he has continued to carry out pancreatic cancer studies in partnership with Washington University and other scientists. In 2016 the national Pancreatic Cancer Action Network awarded Linehan $2 million to continue clinical studies of immunotherapy treatment for patients whose disease has spread beyond the pancreas.