Ryan Devlin:
A Custom Job on Cancer: Glasgow Science Festival
As her talk was entitled, “Of Mice and Men”, she also spoke on the need for mice in research. She explained that results from tissues grown in a petri dish are often not good enough. Development of a new drug costs £1 billion, with most of that money going into Phase II and III trails. As a result, only the best pre-clinical data will justify advancing to Phase II. Pancreatic cancers are about 10% tumour, and 90% fibroblasts, a result of the body’s immune response, and the tumour cells become encased in an immune complex that can make the tumour cells unreachable to drugs. This shows that Pancreatic cancers are a result of the tumour, and the way the body deals with it, and petri dishes don’t have an immune system, metastasis, or a systemic response, and so the need for mice is made.
Next, Dr Stephen Dreyer, Clinical Research Fellow at the University of Glasgow, talked about the emergence of molecularly guided clinical trials, and how they have started to identify patient sub-groups and direct them to the appropriate pilot. Trials, which in the past could take 5-6 years to get going and complete, are now being completed in 2 ½ - 3 years due to increased patient recruitment. In one of the most recent trials, PRIMUS, recruitment was achieved in 9 months.
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We then listened to a patient’s experience of pancreatic cancer, a moving speech that affirmed the need for the new Precision Panc programme.
Pancreatic cancer is the 13th commonest cancer, and the 3rd biggest killer. Its late diagnosis due to very non-specific symptoms often removes surgery as an option, and has meant that there has been very little change in pancreatic cancer survivorship. The cancer is also very different from patient to patient. So how do we start saving more lives?
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In June, Professor Owen Sansom of the CRUK Beatson Institute presented a fascinating evening of talks at the Glasgow Science Festival to try and answer that question.
Dr Jennifer Morton, Associate Scientist at the Beatson, began by explaining the variety of different pancreatic cancers, not divided by tissue type, but by their molecules. It is that very variability in molecular structure and consequently behaviour that is a nightmare when developing drugs. Each cancer is different, so drug trials need to start focusing on even more personalised treatment to make the drug a success.
Finally, Andrew Blankin, who helps to lead the International Cancer Genome Consortium (its HQ residing in Glasgow), and is a part of the Glasgow Precision Oncology Laboratory and ARG (Accelerating Research in Genomic Oncology). He spoke about how we need to personalise treatment for pancreatic cancer, citing that such personalised care is not a paradigm shift, but is the natural evolution of healthcare. He explained, echoing Dr Morton’s comments, how we are now able to divide up cancers, including pancreatic cancer, into a multitude of different types based on molecular structure.
He however noted that our ability to measure differences in disease has outstripped our ability to respond. Reaffirming that we currently treat cancers in blocks, based on tissue, he declared that there was a “Druggable Genome” waiting to be unlocked. The main challenge was money, and the fact that different states can often halt international collaboration – for example, no genomic data can leave Germany, and no tissue can leave the UK.
Overall, the CRUK Beatson presented an engaging, informative and infinitely interesting evening, where, through the lens of pancreatic cancer, those attending learnt about the potential future of not just tumours of the pancreas, but of how we approach cancer in general: Through molecules, and not just tissues.
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