Scientists Make Gains In Treatment, Genetic Risks Of Pancreatic Cancer

December 09, 1996

Johns Hopkins researchers have found that pancreatic cancer patients may live longer if they undergo chemotherapy and radiation after surgery, and that more people than previously thought may have an inherited risk for pancreatic cancer.

The findings provide further insight into the nation's fifth-leading cancer killer and may lead to earlier diagnosis and more effective treatment, say the Hopkins researchers.

Results of the two studies, which were supported by the National Institutes of Health, were presented recently at the annual meeting of the Southern Surgical Association and are published in the December issue of Cancer Research.

In the first study, researchers studied 174 Hopkins patients who underwent a complex surgery known as the Whipple procedure (pancreaticoduodenectomy) for a malignant cancer called adenocarcinoma of the head, neck or tail of the pancreas.

The patients were given three therapy options after surgery: 99 chose standard therapy, which included radiation and chemotherapy (chemoradiation); 21 selected intensive therapy, which included stronger chemoradiation; and 53 declined chemoradiation. (One patient died in the hospital after surgery).

Patients receiving either form of chemoradiation had a median survival rate of 19.5 months compared to 13.5 months for patients foregoing chemoradiation. Median survival rates were 21 months for the standard therapy and 17.5 months for the intensive therapy. The results were independent of tumor size, blood loss during surgery and whether the cancer had spread to the lymph nodes.

"Many patients choose not to receive postoperative chemoradiation therapy, but our findings show it appears to significantly improve survival for all patients," says Charles J. Yeo, M.D., the study's lead author and a professor of surgery. "Early diagnosis, surgery to remove the tumor and postoperative chemoradiation therapy appear to be needed for long-term survival and a potential cure."

The Whipple procedure involves removing part of the pancreas and all of the duodenum (a portion of the small intestine), gallbladder, bile duct and sometimes part of the stomach. Pancreatic cancer is the fifth-leading cause of cancer death in the United States.

In the second study, scientists analyzed tumors and healthy tissue from pancreatic cancer patients and found that 7 percent of the patients had inherited mutations in the BRCA2 gene, which has been linked to breast and ovarian cancer. Scientists also found several new mutations in the gene involved in pancreatic cancer.

Despite the large number of inherited mutations, none of the families involved had a history of pancreatic cancer. That may be, in part, because the disease usually strikes late in life and the cancer never developed because the person died of other causes, says Scott E. Kern, M.D., the study's senior author and an assistant professor of oncology.

"A familial inheritance was thought to be uncommon, but we found an usually high rate," says Kern. "Our results suggest that many people don't think they have a familial susceptibility, but yet they do."

Several genes and mutations have been identified thus far in pancreatic cancer, but Kern says several more may be involved and that actual rate of inherited susceptibility is even higher.

"This is an important first step toward developing a method for early diagnosis," he says. "Early screening is important, but we're still learning what genes and mutations are involved in pancreatic cancer."

Hopkins was joined in the second study by the Henry Ford Hospital and Creighton University School of Medicine.

--JHMI--

Johns Hopkins Medical Institutions' news releases can be accessed on-line through the following services:
World Wide Web at http://infonet.welch.jhu.edu/news/news_releases
CompuServe in the SciNews-MedNews library of the Journalism Forum under file extension ".JHM"; also in NASW Online in same forum.
JHMI toll-free Health NewsFeed BBS at 1-800-JHH-0046.
Quadnet: send email to: scitech@quadnet.vyne.com. In the body of the message type info Quadnet."
To enroll in our direct e-mail news release service, call 410-955-4288.


Johns Hopkins Medicine

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.