In the Clinic

On Cancer: Blood Test Could Predict Which Patients with Pancreatic Cancer May Benefit from Chemotherapy

By Media Staff  |  Tuesday, January 29, 2013
Pictured: Kenneth Yu Medical oncologist Kenneth H. Yu

Pancreatic cancer is one of the most difficult cancers to treat. Because the disease does not cause symptoms in its early stages, pancreatic cancer is usually diagnosed only after it has spread to other parts of the body.

Though progress against pancreatic cancer has been slow, new combinations of chemotherapy drugs have helped to slow the advancement of the disease and extend patients’ lives. However, as the number of effective treatments for pancreatic cancer increases, new challenges emerge as physicians are left guessing which combination of drugs will benefit an individual patient.

Research led by medical oncologist Kenneth H. Yu, presented on January 25 at the American Society of Clinical Oncology’s annual Gastrointestinal Cancers Symposium, suggests that a simple blood test may be able to predict which chemotherapy regimen will work for some patients with pancreatic cancer.

Predicting Sensitivity to Chemotherapy

Dr. Yu and colleagues observed patients who had received one of 12 different chemotherapy combinations as directed by their doctor. They used a new test developed by CellPath Therapeutics that analyzes specific genetic changes found in circulating tumor cells (CTCs) – cells that have broken away from a patient’s primary tumor and entered the bloodstream.

The results of the test predicted how effective a chemotherapy regimen would be. Blood samples for testing were taken before chemotherapy treatments started and again when the cancer progressed.

In this observational study, researchers found that patients on a chemotherapy regimen predicted by the test to be highly effective did not experience cancer progression until they were about seven and a half months into treatment. When the test predicted the chemotherapy would be less effective, patients had progression of their cancer in an average of less than four months.

They also found that when samples were tested later in the treatment process, the specific genetic changes found in patients’ CTCs had shifted, suggesting that this tool can be used throughout the course of therapy to predict when treatment should be altered.

A Step toward Personalized Medicine

Dr. Yu says that the research is encouraging because it “offers a new strategy to personalize cancer therapy. The ability to less invasively predict which patients will respond to treatment as well as provide a signal when treatment resistance occurs is extremely valuable.”

To learn more, read a HealthDay interview with Dr. Yu about these results.

Comments

I am a 12yr+ pancreatic cancer survivor. It was only recently that I had the need to address my surgical report by Dr. Rosato...so sad to hear about his passing, from pancreatic cancer no less. I also look up my pathology report. It was only after looking at both these reports to learn that under microscopic diagnosis I had adenosquamous carcinoma, pancreatic cancer. I have come to learn from the internet that this is a rare type, aggressive pancreatic cancer. I did not have the whipple, but they removed 40% of my pancreas, my entire spleen, a slice of my left kidney, and 5 lymph nodes, (it spread on ly to the first lymph node). Am I correct in my assumption of adenosquamous carcinoma, being a rare, aggressive form of pancreatic cancer?
Best regards,
Russ Carlson
russandurai@comcast.net

Russ, we are not able to answer individual medical questions on our blog. If you would like answers to specific questions about subtypes of pancreatic cancer, we recommend you consult with the National Cancer Institute's Cancer Information Service at 800-4CANCER. You can find more information about the service here: http://www.cancer.gov/aboutnci/cis/page1 Thank you for your comment.

I might add that I had 24/7 of 5fu for 5 weeks, and radiation 5 days a week during the same 5 weeks...devastating! Then 9 weeks of gemzar, 3weeks on 1 off, etc.
Russ Carlson

r Yu I recently was diagnosed with Stage 4 Adeno- carcinoma. Some of the cancer has spread into the liver.Treatment is underway specifically with using Xeloda pills for 14 days then week 4 and 11 using infusion Genzar and Taxitere cocktail GTX.
What other recoomendations would you predict for this agressive type of cancer?

John, we are not able to offer individual medical recommendations or predictions on our blog. If you would like to make an appointment to speak with an MSK physician about your care, you can call 800-525-2225 or go to http://www.mskcc.org/cancer-care/appointment for more information. Thank you for your comment.

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