Could gut bacteria be used to predict the effectiveness of chemotherapy in pancreatic cancer?

The challenge

Chemotherapy is one of the main treatments for pancreatic cancer. It is used to kill cancer cells and aims to slow tumour growth. Chemotherapy is also increasingly being used before surgery, to try to shrink the tumour and make surgery more likely to be successful.

Chemotherapy involves potent drugs which kill cancer cells but also kill healthy body tissue in the process, causing side effects like sickness, infection and tiredness. Not all patients respond to chemotherapy in the same way. Identifying which patients are most likely to respond well to chemotherapy could save those who are unlikely to respond from undergoing harsh treatment that could have a negative impact on their quality of life.

Bacteria in the mouth and gut are thought to play a role in response to chemotherapy. In this project, researchers aim to determine the role that these bacteria play in the effectiveness of chemotherapy for pancreatic cancer, with the hope of ultimately developing a test that can be used to predict response to treatment.

The project

The research team will analyse saliva and faecal samples taken before and after chemotherapy from 73 patients with pancreatic cancer. For each sample, they will study the bacterial communities and the small molecules these communities produce before and after chemotherapy, to uncover whether differences are connected to a patient’s response to the treatment.

They will also use the same approach to investigate how the tumour microenvironment – the cells which surround the tumour – changes during treatment. This microenvironment is made up of many different cells, including immune cells, which can make treatments like chemotherapy less effective.

The hope

The research team hope that the findings from this project could lead to the development of a saliva test to predict which patients are most likely to respond well to chemotherapy, giving patients the opportunity to make informed choices about their treatment.

By identifying patients for whom chemotherapy is unlikely to be effective, it could also prevent thousands of people from undergoing harsh treatment which is likely to have limited benefit.