 |
||||||||||||
| Registered Charity No: 1112708 |
||||||||||||
 |
||||||||||||
| Support our Fundraising click here |
||||||||||||
| Quick Links: | ||||||||||||
|
||||||||||||
|
|
Pancreatic Cancer NewsNovember 2009
£1.9m for cancer diagnosis research
In this summary, they briefly describe the whole programme. One very pleasing point from the viewpoint of our cancer charity (after discussion in various meetings with members of the team), is that they selected pancreas as being of particular interest; indeed, it, lung and colorectal are highlighted throughout the whole programme. Dr Willie Hamilton of Bristol University said "Cancer is common - a quarter of people in the UK will die from it. Most patients with cancer attend their doctor after a symptom, such as bleeding, is experienced. Patients often seek help later in the UK than other countries, but the reasons for this are not fully understood. Even after a doctor is involved delays may occur. Doctors may not think the symptom is cancer, or they may send the patient to the wrong speciality. GPs actually see few cancers each year, so do not build up much personal experience and, understandably, sometimes make mistakes. Around 7,500-10,000 lives a year are lost from later diagnosis. We need a thorough study of the reasons why cancer diagnosis may be delayed, and to consider new designs for testing for cancer. The programme tackles that. The first area for study is symptoms before they are reported to doctors. We are studying patients suspected to have one of three main types of cancer (colon, lung, pancreas), to find out about their symptoms, what prompted them to seek help, and what caused any delays in seeking help. This will be done by specially-designed questionnaires and in-depth interviews. The second area examines what happens once a symptom is reported. Although we know the risk of cancer for a few symptoms, in many we have no real idea of their genuine importance. We will use the General Practice Research Database (a massive database containing the anonymised records of ~3m UK people) to work out precisely the risk of cancer with particular symptoms for all the important cancers that have not been studied before. We will also use this database to map out where and when patients with colon, lung or pancreatic cancers are referred, mainly to identify where errors in referral occur. The third area looks at how new services could be designed - for instance, what level of risk of cancer actually needs testing. This is not simple: cancer tests can be uncomfortable and may be risky; sometimes an early diagnosis of cancer may not save the patient's life. We have designed a large survey aimed at finding out what the public thinks, using examples of the upsides and downsides of testing; public views will make a vitally important contribution. With this information we will design services - first from an economic viewpoint, seeing what is the most cost-efficient design of cancer testing. Finally, we will use all the results in two Primary Care Trusts to design real-life services, and test them out." October 2009 The results of the GemCAP trial have been published in the Journal of Clinical Oncology. September 2009 The Fragem trial results were presented at ECCO and highlighted in the Congress newspaper - see article April 2009 Although 5 year survival rates for pancreatic cancer in the UK show no change the 1 year survival rates are continuing to rise. The "Survival Rates in England, patients diagnosed 2001-2006 followed up to 2007" published by the Office of National Statistics show for men the age standardised 1 year survival is now 15.3% (15.8% unstandardised) and for women 15.9% (14.5% unstandardized). The 1 year survival rate decreases with age so that for men below age 50 it is 26% and women 38% dropping to 23% and 27% at age 50-59 and 20% at age 60-69. The paper "Population-based cancer survival trends in England and Wales up to 2007: an assessment of the NHS cancer plan for England" by Bernard Rachet, Camille Maringe, Ula Nur, Manuela Quaresma, Anjali Shah, Laura M Woods, Libby Ellis, Sarah Walters, David Forman, John Steward, Michel P Coleman and published in The Lancet Oncology ( www.thelancet.com/oncology Vol 10 April 2009 ) shows that for England the pancreas 1 year relative survival for men has increased from 14.8% for those diagnosed in 1996-2000 to 17.3% for those diagnosed in 2004-2006 and for women from 13.2% to 16.4% in the same period. Similarly for Wales the 1 year survival for men has increased from 14.6% to 17.3% and for women from 11.0% to 16.2%. There are similar trends in Scotland with 1 year relative survival for men (15-99) increasing from 11.3% for those diagnosed in 1980-1984 to 15.0% for those diagnosed in 2000-2004 and for women increasing from 13.5% to 17.3% in the same period (Trends in Cancer Survival 1980-2004, Scottish Cancer Registry). March 2009 Pfizer has stopped the phase 3 clinical trial of its drug Sutent (sunitinib malate) in a rare form of pancreatic cancer (islet cell tumours, also known as pancreatic neuroendocrine tumors) early because the drug showed significant benefits in patients. It is an oral multi-kinase inhibitor (blocks the action of molecules that help the cancer to spread). Sutent is an oral targeted agent that works by inhibiting multiple biologic pathways involved in the growth, replication, and spread of cancer cells. Sutent deprives cancer cells of blood and nutrients needed for growth. It was trialled in well-differentiated advanced/metastatic pancreatic islet cell tumor that had shown progression within the previous year. The independent Data Monitoring Committee (DMC) that was overseeing this trial recommended it stop after finding that the drug had shown greater progression-free survival compared to placebo (patients lived longer without the cancer spreading), and best supportive care in patients with pancreatic islet cell tumors, said Pfizer in a press statement. Once the trial data is fully analyzed, it will be presented at a scientific meeting, they added. Pancreatic islet cell tumors are rare, with an incidence of 5 to 10 per million worldwide annually. Such tumors include insulinomas, glucagonomas and gastrinomas, and current treatment options are limited. They account for only about 5% of pancreatic cancer tumours. The participating centres have now been informed of the decision, so all the patients taking part in the trial can choose to continue on Sutent or switch from placebo to the drug. The full results will need to be fully analysed to ensure that the benefits are found to be significant . If they are the drug will need to be licenced for use in pancreatic islet cell tumours and NICE approval will need to be obtained before it can become available for patients. September 2008 The complete genetic blueprint for pancreatic cancer, one of the most lethal of all of the cancers, was decoded by a team at the Sol Goldman Pancreatic Cancer Research Center at Johns Hopkins. The study, led by Drs. Vogelstein, Kinzler and Velculescu, is reported in the Sept. 5, 2008, issue of Science Express. The team sequenced more than 20,000 genes in a series of 24 well-characterized pancreatic cancers and discovered over 1,500 DNA mutations in these cancers. An average of 63 mutations was found in each cancer, supporting the growing body of evidence that cancer is fundamentally a disease caused by alterations in the DNA. The complex picture presented by these mutations was simplified by the finding that many of them acted in concert through a set of well-defined signaling pathways and processes. The scientists identified 12 core signaling pathways and processes that were each altered in more than two-thirds of the cancers. These 12 core pathways will provide the basis for novel diagnostic and therapeutic approaches in pancreatic cancer. As a part of the study the team also discovered over 500 genes that were made at abnormally high levels in the 24 cancers. Fifty-four of these over expressed genes were predicted to be secreted or made on the surface of the cancer cells, suggesting that these genes may be useful therapeutic targets or may form the basis for new tests for the early detection of pancreatic cancer. The landmark study characterizes the fundamental genetic components of pancreatic cancer and will guide research on this disease for the next decade. The improved understanding realized from these studies, and their follow-up work will hopefully lead to dramatic improvements in the prevention, detection, or treatment of pancreatic cancer. The team also managed to draw a map of the genetic mutations involved in glioblastoma, the most common form of brain cancer - this and pancreatic cancer are two of the most agressive cancers. They show that cancer is very complicated with many genetic changes. Researchers found 12 pathways - a series of successive molecular changes in a cell - that were abnormal in most of the tumors. The findings offer a different perspective from the approach currently taken by most drug companies, suggesting that it may be more productive to target the specific pathways. The genomic analysis found an average of 63 genetic alterations in pancreatic cancer and 12 cellular pathways. The average brain tumor had 42 genetic alterations, researchers found. The 12 pathways in pancreatic cancer were altered in between 67 and 100 per cent of tumours and included pathways linked to DNA damage control, cell maturation and tumour invasion. Dr Bert Vogelstein, co-director of the university's Ludwig Centre and a researcher at the Howard Hughes Medical Institute, commented: "This perspective changes the way we think about solid tumours and their management, because drugs or other agents that target the physiologic effects of these pathways, rather than individual gene components, are likely to be the most useful approach for developing new therapies." This shows why pancreatic cancer is so resistant to treatment by current drugs. Scientists hope the findings may eventually lead to the discovery of better treatments, new diagnostic tests and new drugs or earlier surgery to give the best chance of survival from the disease. According to Dr Kenneth Kinzler, professor of oncology and co-director of the Ludwig Centre, the various human cancers are "clearly more complex than has been previously appreciated"."Fighting it is going to be more of a guerrilla war than a conventional one because there are dozens of mutated genes in each tumour," the expert claimed. "Individually, these mutations don't seem formidable. But working together, they form an enemy that will require us to develop novel strategies to combat them, and the best long-term strategy may be early detection of tumours, when the number of guerrilla warriors is still small and more easily handled." The research was funded by a number of charitable foundations in the USA and the USA National Institute of Health. August 2008 Les Niewiara, Pancreatic Cancer UK patient representative, completes his bike ride to Poland with friends, family and fellow survivor Trace Allen and releases his book "Bike to the Future" which is the story of how during the course of 14months, Les Niewiara undertook two unplanned journeys, both of which will stay with him for the rest of his life. It covers the first 14months following his diagnosis of pancreatic cancer and including subsequent surgery and chemotherapy and then his first bike ride from Bolton's Reebok Stadium to Hammersmith Hospital in 2004. Contact us if you are interested in purchasing a copy for minimum donation of £10 plus post and packaging with profits coming to PCUK. Les is currently undergoing tests to try to discover the reason for ongoing internal blood loss and we wish him well. August 2008 The NCIN(National Cancer Intelligence Network) formed as part of the Cancer Reform Strategy has released the 1 year survival rates in its e-atlas. This shows that although the overall survival rate for pancreatic cancer remains low at least the 1 year survival rate has increased from 12.3% to 15.8% between 1985-1989 and 2000-2004 with men having a slightly higher survival rate than women of 16.8% v 14.8% respectively. There is a variation between different areas of the country with Surrey, N, SW and W London having 1 year survival rates in 2001-2005 of 23.5,21.8,21.3 and 20.8% respectively with North Trent having the lowest 1 year survival rate of 10.7%. Analysis of the reasons for this variation will be very interesting. Is it related to availability of trials, 2nd line treatment, affluence, age profile of local population, or general fitness or other causes? 1 August 2008 The University of Liverpool and the Royal Liverpool University Hospital have been awarded £5 million to establish a new Biomedical Research Unit. The facility will specialise in pancreatic digestive diseases (including both cancer and pancreatitis), focusing on “translational research”, offering a direct link between University and the hospital trust and allowing patients to benefit more quickly from scientific breakthroughs. The National Institute for Health Research (NIHR) Biomedical Research Unit will be based at the Royal Liverpool University Hospital. One of only 15 nationwide, it will be only unit dedicated to diseases of the pancreas. The funding will provide facilities, equipment and new staff to translate Liverpool’s research advances into better outcomes for patients. 23 April 2008 Closing date for bids for NIHR(National Institute for Health Research) Health Technology Assessment programme for trials of the use of FDG-PET or PET/CT in the diagnosis of pancreatic malignancy. Primary research consisting of 1) a diagnostic accuracy study to investigate the value of FDG-PET or PET/CT in patients with suspected pancreatic cancer, and 2) using the estimates of improvement in diagnostic accuracy, undertake modelling to assess any additional value of FDG-PET or PET/CT after usual investigations on management and treatment outcomes. Researchers should identify the groups of patients in whom FDG-PET or PET/CT adds most value and make recommendations for further research. 3 December 2007 Government's Cancer Reform Strategy released. It states: "Looking forward 1.11 While the outlook for cancer has been transformed over the past decade, major challenges remain:.... Survival rates for some poor prognosis cancers have remained largely unchanged, such as for lung cancer and pancreatic cancer, partly due to difficulties in diagnosing these cancers early" and "Screening for other cancers 3.35 The cancer research community is committed to investigating screening approaches in other cancers, particularly in the most common forms of cancer where a national screening programme is most likely to be cost effective. Research is also underway into biomarkers of early cancers where patients often have no symptoms until the cancer has reached a very late stage, such as pancreatic cancer. We will continue to support and monitor this research and evaluate the potential for the introduction of new screening technologies as the evidence develops, working closely with the UK National Screening Committee." and " 4.14 For many cancers, surgery is used as the first treatment. In these cases, over 99% of patients requiring surgery are being treated within 31 days under the current standard. However, for some cancers such as bladder, pancreatic and skin cancer, it is relatively common for definitive surgery not to be the first procedure. 4.15 Under the new extension to the 31 day standard NHS Trusts will need to ensure that patients undergoing definitive surgery as a second or subsequent treatment do not experience delays." The importance of this final statement is that for many patients stenting to relieve jaundice is the first treatment and so there had been no waiting time target for the subsequent surgery. July 2007 Cancer Research UK held a workshop to discuss needs for research into pancreatic cancer to inform its research strategy 20 March 2007 The Cancer Campaigning Group (of which PCUK is a member) launched its White Paper "Getting it Right for People with Cancer: What the Voluntary Sector wants from the Cancer Reform Strategy" at the House of Commons. This highlighted the vital need to improve survival rates for pancreatic cancer.
International news from PancreasWeb.com |
| Last updated 29th November 2009 |