• Pancreatic cancer is really four separate diseases with specific genetic triggers that require individualised treatment. (Flickr)Source: Flickr
Scientists have discovered there’s not one, but four different types of pancreatic cancer and 10 different ways a damaged gene can turn healthy pancreas tissue into a cancerous tumour.
By
Yasmin Noone

25 Feb 2016 - 1:01 PM  UPDATED 25 Feb 2016 - 1:02 PM

Pancreatic cancer is really four separate diseases with specific genetic triggers that require individualised treatment, a new Australian-led study has discovered.

International research, published in the journal Naturetoday, reveals that there are four sub-types of pancreatic cancer and 10 ‘damaged’ genetic processes that turn normal pancreatic tissue into cancerous tumours.

Some of these processes are related to bladder and lung cancers, opening up the possibility of using treatments for these cancers to also treat pancreatic cancers.

For study lead and director of research at the University of Melbourne Centre for Cancer Research, Professor Sean Grimmond, knowledge is power. Understanding which subtype of pancreatic cancer a patient has will clear the path for a more accurate diagnosis and treatments tailored to an individual’s own molecular makeup.

Some of these processes are related to bladder and lung cancers, opening up the possibility of using treatments for these cancers to also treat pancreatic cancers.

“If you take 10 people with cancer, it’s not the same story every time,” says Prof Grimmond, the Bertalli Chair in Cancer Medicine.

“There are lots of things that can go wrong to cause that cell to go out of control.

“In the past, we’ve used a 300-year-old instrument, the microscope, to look at 20 tumours so in the end, they all look the same.

“But if you look at them on a molecular level, they are all different and they all react to drugs differently.

“What we found was four subtypes of pancreatic cancer and 10 really important cellular processes that seem to be recurrent in damaged DNA, across our studied cohort.”

Prof Grimmond explains that over the seven-year investigation, scientists also learned that some strains of pancreatic cancer bear similar genetic mutations to other cancers like colon, leukaemia, bladder and lung cancer.

That means pancreatic cancer sub-types could be treated with drugs designed for these diseases.

The discovery, which came from analysing the genomes of 456 pancreatic tumours, could also lead to treatments that tackle chemotherapy resistant genes.

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Prof Grimmond, who will head the new Victorian Comprehensive Cancer Centre Project when it opens in June, says he wants to start testing new treatments for the subtypes of pancreatic cancer in medical trials next year.

“We see clear directions on where the research has to go and the onus is on people like me to push this research data forward into rapid clinical tests.

“It can’t be rushed but hopefully we can make progress in stages. I am confident that we will have the first stage of [human] trials available in 2017.”

Grace King, 54, is currently a pancreatic cancer patient The Royal Melbourne Hospital.

Her cancer is at stage four and to-date, chemotherapy has failed to treat her condition. Last year, she was given only months to live before being offered a place in a molecular testing medical trial.

King has since been given treatment that targets her individual cancer-causing gene.

“I’ve had two CT scans since I started this treatment and it has actually stabilised the tumour, which is wonderful,” says King.

“Chemotherapy may work for some people but it didn’t work for me. However, I am still confident that this method will work.”

King says the new research findings come as good news, providing her hope that whether or not her current treatment works, she will still be cured.

“I didn’t realise there were so many strains of pancreatic cancer until just a few days ago. It’s quite important research that needs to get done so we can find out what treatments will suit each person’s genetic makeup – what’s good for me may not suit someone else and what suits someone else may not suit me.

This study gives us patients a glimpse of hope that they can find the [gene] to target with medication. It’s just so vital.

“This study gives us patients a glimpse of hope that they can find the [gene] to target with medication. It’s just so vital.”

Prof Grimmond estimates around 85 per cent of patients with pancreatic cancers will die within a year. The condition is also predicted to become the second most common cancer in the western world within a decade.

For this reason, he says, there is an urgent need for more research into the genetic causes of pancreatic cancer and cures.

It is yet to be investigated whether there are four different cells that live in the pancreas that can become cancer or if there are four stages that form the path from the least aggressive type of pancreatic cancer to the most aggressive.

The research team included Professor Andrew Biankin from the Garvan Institute of Medical Research and the University of New South Wales and bioinformatician Dr Nicola Waddell, now based at QIMR Berghofer Medical Research.

This study builds on earlier studies performed by the team as part of the International Cancer Genome Consortium (ICGC).

Image from Flickr/Wellcome Images.