Pancreatic cancer is 'four different diseases'

A collaboration between scientists from around the world has identified four subtypes of pancreatic cancer.

According to the research group, the discovery of these subtypes could lead to new and personalised treatments for pancreatic cancer.

'This is the most comprehensive analysis of the blueprint of pancreatic cancer,' said Professor Andrew Biankin, a senior author of the study from the Institute of Cancer Sciences at the University of Glasgow. 'So this knowledge reveals what makes these cancers tick and which ones may be vulnerable to particular treatments by defining the Achilles' heel of every cancer.'

The team analysed the genomes of 456 pancreatic ductal adenocarcinomas – a common form of pancreatic cancer – to look at the genetic pathways involved in the development of the disease. The researchers, from Australia, the US, Germany, Italy and the UK, published their results in Nature.

'We identified 32 genes from ten genetic pathways that are consistently mutated in pancreatic tumours. But further analysis of gene activity revealed four distinct subtypes of tumours,' said Professor Sean Grimmond of the University of Melbourne Centre for Cancer Research in Australia, who led the study.

The research team dubbed these four subtypes as: squamous; immunogenic; pancreatic progenitor; and aberrantly differentiated endocrine exocrine tumours.

Pancreatic cancer is the fifth most common cause of cancer-related death in the UK and is notoriously hard to treat. The five-year survival rate is less than three percent and has remained unchanged since the 1970s. There are large differences in survival rates between the different types.

'It's just a really tough cancer,' Dr Biankin told BBC News. He added that there is hope that matching drugs to specific mutations in tumours could help patients. 'The fact that we see, through chance, that some patients respond exceptionally to a particular therapy allows us to expand these insights so we can treat more patients with similar cancers at a genetic level.'

Leanne Reynolds, head of research at Pancreatic Cancer UK, who was not involved with the study, said: 'The findings of this research are incredibly exciting. If we can predict more accurately which treatment would be most effective for each patient, we can ensure patients have the best chance of living for as long as possible, as well as possible.'

Currently, other research groups are testing treatments for other types of immunogenic tumours. Professor Grimmond's team wants to investigate whether such treatments could work for immunogenic pancreatic cancers.

Initiatives, such as Know Your Tumor in the USA, also intend to capitalise on this research by offering personalised medicine through the profiling of pancreatic tumours, which can aid clinicians to choose the best treatment plan for the patient.