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Six-Gene Signature Predicts Survival of Patients with Localized Pancreatic Ductal Adenocarcinoma
More than 43,000 people in the United States are diagnosed with pancreatic cancer each year. It begins when a cell in the pancreas (an organ lying behind the stomach that produces digestive enzymes and hormones such as insulin, which controls blood sugar levels) acquires genetic changes that allow it to grow uncontrollably and to spread around the body (metastasize). PDAC, which constitute 90% of all primary malignant tumors arising from the pancreatic gland, rarely causes any symptoms early in its development and has already metastasized in about half of patients before it is diagnosed.
Approximately 25% of patients with resectable PDAC, however, survive for more than five years after surgery, causing researchers to wonder if some people have a less aggressive form of PDAC determined by the biology of the primary tumor. If this is the case, doctors and patients could factor in this information when making decisions about treatment options.
A multicenter study including Lurie Cancer Center member David J. Bentrem, MD, Harold L. and Margaret N. Method Research Professor of Surgery at Northwestern Medicine, has identified a six-gene signature that can predict outcomes in patients with localized, resectable pancreatic ductal adenocarcinomas (PDAC) better than, and independently of, established clinical markers of outcome. If the predictive ability of this signature can be confirmed in additional patients, it could be used to help patients make decisions about their treatment. For example, a patient considering the Whipple procedure (1%–3% of patients die during this operation and 30% - 40% have serious postoperative complications), might choose to have the operation if they knew that they had a low-risk tumor. Conversely, a patient in poor health with a high-risk tumor could take that knowledge into consideration when deciding whether to undergo major surgery. The six-gene signature might also help clinicians decide which patients would benefit most from neoadjuvant therapy. Finally, the genes in this signature, or the biological pathways in which they participate, might represent new therapeutic targets for the treatment of PDAC.
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