Pancreatic cancer remains the mostly deadly common solid tumour in developed countries. Only 20 per cent of patients present with operable disease and surgery results in long-term survival for about 15-20 per cent of these latter patients; therefore, overall survival of all patients is less than five per cent. Advances in combating this aggressive disease rely on establishing and maintaining efficient registries and databases of incident cases from high volume centers where fresh biospecimens can be obtained, followed by detailed molecular analysis of tumours to uncover the pathways driving tumour growth and dissemination. These steps are essential for the development and testing of drugs targeting these pathways. In addition, the development of new tools for early detection and diagnosis is of critical importance.
Personalized medicine, meaning choosing the right drug (or surgery), for the right patient, at the right time, is the new paradigm driving clinical care and novel personalized approaches for patients with advanced cancer are available in Israeli and Canadian cancer centers. However, there remains a dearth of precious clinical and research biospecimens (blood and tumours) from the majority of pancreas cancer patients who present with inoperable (metastatic) disease. The systematic collection of pancreatic tumour specimens is therefore an essential step in this process, as is the development and application of the technologies allowing their molecular dissection. The recent dramatic leap offered by novel “Next Generation Sequencing” technologies, which allow rapid low-cost view of global gene structure and activity in multiple tumours, provide renewed optimism regarding progress in understanding the biology of pancreas cancer as well its treatment.
Here we propose a research program that brings together the expertise and power of the University of Toronto/Mount Sinai Hospital/Lunenfeld-Tanenbaum Research Institute/Ontario Institute for Cancer Research (OICR), and the Faculty of Medicine of the Hebrew University of Jerusalem. This program is aimed at augmenting robust infrastructures in the form of a biospecimen and clinical registry, in which pancreatic cancer samples will be collected and stored for molecular analysis. These collected samples will serve as the basis for molecular analyses aimed at uncovering the molecular landscape of pancreatic cancer and the pathways driving the disease. These studies will focus on uncovering the global profile of gene activity and its regulation within tumours, major mutational events and key signaling pathways active within these tumours driving tumour growth and metastatic dissemination.
This effort brings to effective synergies utilizing the power of multiple institutions. Dr. Steven Gallinger (Toronto), together with Dr. Talia Golan at Sheba Medical Center, will continue to identify incident cases of pancreas cancer and build the biospecimen and clinical registry infrastructures, for their ongoing productive academic collaborations and for the broader group of investigators. OICR is a world leader in employing state-of-the-art technologies for high-throughput molecular analysis of tumours (i.e., DNA, RNA and protein activity), and its platforms will provide the support for extracting this molecular data for this project. Researchers at the Hebrew University Faculty of Medicine are conducting cutting-edge research in the study of gene activity regulation and cell signaling in cancer, and, relying on the collected patient specimens, will conduct detailed molecular analyses and experimental studies. Together these efforts will reveal key molecular events occurring during the progression of pancreatic cancer and underlying its malignancy. This will provide biomarkers for detection, diagnostics, and potentially for molecular targeting of the disease relying on these markers, with a great potential to impact the treatment of the disease.