Narrowing the gap toward precision medicine for pancreatic cancer

January 19, 2018 by Laura Oleniacz, University of North Carolina at Chapel Hill School of Medicine

University of North Carolina Lineberger Comprehensive Cancer Center's Jen Jen Yeh, MD, is working to understand the complicated relationship between one of the deadliest cancers and the web of connective tissue that can surround the tumors.

In a new study, Yeh helped uncover findings about the role of the matrix of tissue called "" in , and in another, she helped identify the role of molecular subtypes in therapy response. Pancreatic cancer's five year survival rate is 8 percent in the United States, and researchers hope to improve that.

One of the challenges in treating pancreatic cancer is that while stroma can block treatment from reaching the tumor, Yeh said it may also prevent the tumor from spreading.

"As many elegant studies have found, stroma in pancreatic cancer is a double-edged sword – it can be both protective and promoting," said Yeh, who is a UNC Lineberger member, a professor in the UNC School of Medicine Division of Surgical Oncology and the vice chair for research in the Department of Surgery.

In a study in JCO Precision Oncology that Yeh co-led with Eric A. Collisson, MD, at the University of California, San Francisco, the researchers analyzed levels of stroma surrounding pancreatic cancer tumors, and in distant metastatic sites.

They found the primary tumors had a significantly higher stromal density than the cancer that had spread to solid organs. In addition, with a higher stromal density in their primary tumors had longer survival than other patients, a finding that can be analyzed using non-invasive methods, such as a CT scan.

Since they discovered that stroma is important to survival, Yeh said their findings suggest that physicians need to think before taking away the stroma on patients for whom their stroma is protective. That makes detecting stroma density at the outset particularly important.

"The vast majority of pancreatic cancer patients die with metastases, so therapies are targeted to metastatic disease," Yeh said. "The finding that different sites of pancreatic cancer have different amounts of stroma may have therapeutic implications, especially with the increasing interest in stroma-modulating therapies."

In a previous foundational study, Yeh characterized the biologic patterns in tumors and in stroma. She found that patients can have different biological or molecular types of tumors as well as stroma, and that both types are linked to outcomes. In a separate, recent Clinical Cancer Research study she co-authored, Yeh and colleagues, including those from the Princess Margaret Cancer Centre in Ontario, Canada, found that patients with one subtype of were more responsive to treatment than were patients with a different subtype.

"These studies emphasize the potential importance of individualizing therapies for specific tumor characteristics, and the need to develop ways to identify these characteristics with either biopsies or noninvasive imaging approaches," Yeh said.

Explore further: Pancreatic cancer subtypes discovered in largest gene expression analysis to date

More information: Robert J. Torphy et al. Stromal Content Is Correlated With Tissue Site, Contrast Retention, and Survival in Pancreatic Adenocarcinoma, JCO Precision Oncology (2018). DOI: 10.1200/PO.17.00121

Related Stories

Pancreatic cancer subtypes discovered in largest gene expression analysis to date

September 9, 2015
Dense surrounding tissue can block drugs from reaching pancreatic cancer tumors, but it can also help prevent the cancer from spreading. Now a new study by UNC Lineberger Comprehensive Cancer Center researchers and collaborators ...

Eliminating cellular stroma could enable anti-cancer drugs to penetrate tumor tissues, improve survival

February 24, 2015
Like a stealth jet cloaks itself from radar, cancer cells cloak themselves within tumors by hiding behind a dense layer of cellular material known as stroma.

New insights on the addictions of tumors

October 6, 2017
Researchers at Sanford Burnham Prebys Medical Discovery Institute (SBP) and UC San Diego have shown that tumors can ensure a more reliable nutrient supply by eliminating the p62 protein in surrounding stromal tissue. Specifically, ...

Pancreatic tumors may require a one-two-three punch

January 15, 2018
One of the many difficult things about pancreatic cancer is that tumors are resistant to most treatments because of their unique density and cell composition. However, in a new Wilmot Cancer Institute study, scientists discovered ...

Blocking enzyme in normal cells may impede pancreatic cancer, team shows

October 28, 2017
Cancer of the pancreas is a deadly disease, with a median survival time of less than six months. Only one in 20 people with pancreatic cancer survives five years past the diagnosis. The reason is the cancer's insidiousness; ...

A microRNA may provide therapy against pancreatic cancer

June 25, 2015
Indiana University cancer researchers found that a particular microRNA may be a potent therapeutic agent against pancreatic cancer. The research was published June 22 in the journal Scientific Reports.

Recommended for you

Scientists discover new method of diagnosing cancer with malaria protein

August 17, 2018
In a spectacular new study, researchers from the University of Copenhagen have discovered a method of diagnosing a broad range of cancers at their early stages by utilising a particular malaria protein that sticks to cancer ...

Developing an on-off switch for breast cancer treatment

August 17, 2018
T-cells play an important role in the body's immune system, and one of their tasks is to find and destroy infection. However, T-cells struggle to identify solid, cancerous tumors in the body. A current cancer therapy is using ...

Pregnant? Eating broccoli sprouts may reduce child's chances of breast cancer later in life

August 16, 2018
Researchers at the University of Alabama at Birmingham have found that a plant-based diet is more effective in preventing breast cancer later in life for the child if the mother consumed broccoli while pregnant. The 2018 ...

Three scientists share $500,000 prize for work on cancer therapy

August 15, 2018
Tumors once considered untreatable have disappeared and people previously given months to live are surviving for decades thanks to new therapies emerging from the work of three scientists chosen to receive a $500,000 medical ...

PARP inhibitor improves progression-free survival in patients with advanced breast cancers

August 15, 2018
In a randomized, Phase III trial led by researchers at The University of Texas MD Anderson Cancer Center, the PARP inhibitor talazoparib extended progression-free survival (PFS) and improved quality-of-life measures over ...

New clues into how 'trash bag of the cell' traps and seals off waste

August 15, 2018
The mechanics behind how an important process within the cell traps material before recycling it has puzzled scientists for years. But Penn State researchers have gained new insight into how this process seals off waste, ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.