The pancreatic cancer programme has established itself considerably over the past two years, since our clinical team of three medical oncology consultants began to work together for the first time in September 2009. Additionally, with Cambridge BRC and CRUK support we recently hired two research nurses and a data manager.
Our pancreatic cancer clinical research team has formulated and successfully opened two investigational trials for pancreatic cancer patients, with each trial springing from our own laboratory-based scientific discoveries.
Our first is a Phase 1-2 clinical trial and involves patients with metastatic pancreatic cancer, where a novel therapeutic strategy using gamma secretase inhibition in combination with gemcitabine will assess our hypothesis that this approach will lead to profound tumour necrosis and a survival advantage for patients. This trial is led by Prof Duncan Jodrell in Cambridge, and we are the first in the world to propose this approach.
Our second trial will determine whether 18-F-deoxyglucose can serve as a tracer to determine early response in patients with advanced pancreatic cancer, since we showed in 2009 (Olive et al, Science June 2009) that pancreatic tumours are poorly perfused. Dr David Tuveson directs this trial, involving 5 sites in the UK.
Finally, Dr Tuveson is directing an additional trial that opened early in
2011, for patients prior to resection of pancreatic tumours. This trial will determine whether Hedgehog inhibitors decrease the tumour stroma and impact upon the tumour vasculature.
To propose these trials, we had to first develop a new method of obtaining tumour biopsies that are sufficient for scientific analysis. Therefore, over the past two years, our team of pathologists, radiologists, surgeons and medical oncologists has modified the processing of small needle biopsies that are obtained during endoscopic ultrasound such that the biopsies are now accurate histological representations of the tumour. Our work has shown that our new approach is diagnostically superior to the aspirates performed routinely, and also is more economical. We are currently writing up this method for submission of a manuscript.