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TRI provides the significant help to treat advanced pancreatic cancer
TRI provides the significant help to treat advanced pancreatic cancer. A Patient with advanced pancreatic cancer tell their anti-cancer experience: TRI helps me through the difficulties.
The treatment of tumors is a difficult problem, requiring the synthesis of various data. It also kills cancer cells accurately.
When Drew Huggins recalled the good news about pancreatic cancer treatment by the clinical trial coordinator on the phone, he still couldn’t hide his excitement.
“It was the physical therapy clinic that my two brothers drove me to. I was too weak to even drive the car by myself.” Drew Huggins recalled. At this time, Yang Jing told him that a new experimental drug was working. MD Anderson Cancer Center conducts clinical trials for this drug to precisely target cancer genes. “It was that call that gave me new hope.”
▌The strange pain is actually pancreatic cancer
Oncologist Dr. Michael Castro (who has been awarded the “Top Doctors in the United States” for many years) pointed out that pancreatic cancer is one of the cancers with the worst prognosis and is known as the “king of cancer.” In recent years, the incidence of pancreatic cancer has been on the rise, with insidious onset and lack of specific symptoms in the early stages. Most patients have missed the best time for treatment.
Two years ago, Drew Huggins began to feel chest pain, stomach pain, and the pain radiated to his back. He underwent an MRI examination locally, and the doctor found the cause of the pain: There was an egg-sized tumor in his pancreas, which was malignant and had spread to the liver. “The tumor compressed my spine and caused back pain, while chest pain was caused by three tumors that spread from the pancreas to the liver.”
▌The treatment failed many times, and the side effects made me feel painful
Drew Huggins was referred to MD Anderson Cancer Center. Oncologist Dr. Janet Tu first used FOLFIRINOX quadruple chemotherapy. According to the treatment plan, Drew Huggins was supposed to receive 18 cycles of treatment, but after the 13th cycle, a reexamination of MRI showed that the treatment effect was not good.
Drew Huggins then received gemcitabine + paclitaxel chemotherapy, and the original 18-cycle treatment program was forced to stop after only 4 cycles. The new plan was also ineffective. The tumor continued to spread, and he was also troubled by the side effects of the drug, including weakness, numbness, and pain in his hands and feet.
The standard chemotherapy failed, and the doctor advised Drew Huggins to try a new treatment. Gastrointestinal oncologist Dr. Shubham Pant suggested that Drew Huggins participate in a clinical trial of an antibody conjugate (ADC) under investigation. This kind of drug attaches the anticancer drug to the antibody drug, thereby enhancing the efficacy of the drug. New drugs are like “scud missiles” that use antibodies to precisely target tumors and then release cytotoxic drugs to kill cancer cells.
However, the treatment did not work for Drew Huggins, and his tumor increased by 25%.
▌New targeted drugs bring new hope
When the mountains and rivers are exhausted, Dr. Pant suggested that Drew Huggins’ tumor tissue be sent to the laboratory for further genetic testing-comprehensive genome sequencing analysis. If cancer driver genes and mutations are discovered, they can accurately match anticancer drugs that target their specific mutations.
“In pancreatic cancer patients, only a small percentage of them carry mutations that can be targeted.” Dr. Pant pointed out. “Although the chances are slim, it is still worth a try. Because if you don’t try, you will never find these mutations.”
This time, the God of Luck favored Drew Huggins. Comprehensive genome sequencing analysis revealed that there was a rare NRG1 fusion (the NRG1 gene fused with another unrelated gene) in his tumor. NRG1 fusion will produce too much NRG1, causing uncontrolled cell proliferation, which in turn leads to the occurrence and development of cancer.
NRG1 fusion only occurs in 1.5% of pancreatic cancer patients, and Drew Huggins is one of them. This means that he can participate in a clinical trial of a new targeted drug Zenocutuzumab (MCLA-128) for the treatment of NRG1-related cancers.
Zenocutuzumab is a new type of bispecific antibody drug. In July last year, the drug was granted the title of “orphan drug” by the US FDA; in January this year, the US FDA granted it a “fast track” designation.
▌Customized precise treatment plan for patients with pancreatic cancer
“Each patient’s pancreatic cancer is different.” said Dr. Jordi Rodon Ahnert, head of the MD Anderson branch of the international genetic clinical trial organization, who is good at early drug development and precision medicine.
“A one-size-fits-all approach will not work,” he said. “The same two pancreatic cancer patients, but they may be genetically different. Molecular sequencing of tumor DNA and RNA can help us tailor it for each patient. The best treatment plan.”
The new guidelines issued by the American Society of Clinical Oncology last year also recommend that patients with metastatic pancreatic cancer who have progressed or become intolerable after first-line chemotherapy and may benefit from further treatment should undergo genetic testing as soon as possible.
▌Pancreatic cancer treatment is moving towards individualization
Since entering the clinical trial in September last year, Drew Huggins’s body has continued to improve: weight has increased, pain has been significantly reduced, and he has become more energetic.
Today, Drew Huggins’s tumor is shrinking rapidly. Laboratory tests and imaging examinations found no signs of tumor activity, and he no longer has to worry about the side effects caused by chemotherapy. A recent review showed that Drew Huggins’ CA199 level dropped by 90% compared to when he first joined the group.
“Every time I go to the review, the situation is getting better.” Drew Huggins said that because of such remarkable progress, he is now even invited to join the MD Anderson Cancer Personalized Treatment Institute’s “super responder project.” In this project, participants who responded particularly well to treatment donate their tissue samples for scientific research.
“Cancer treatment is becoming more personalized. Advances in genetic testing technology provide us with targeted and precise targeting for the treatment of pancreatic cancer, providing new hope and direction.” Dr. Castro suggested that pancreatic cancer patients should be as comprehensive as possible. In-depth genetic testing. “The deeper the research on tumors, the more insight into its root causes, and the more likely it is to find mechanisms that can target the destruction of tumor growth, overcome drug resistance, eliminate tumors, and alleviate the condition.”
▌New breakthrough in personalized treatment of pancreatic cancer: TRI “sand table deduction” accurately predicts tumor response
The results of a clinical study (myCare-009-05) led by Dr. Eileen O’Reilly, Chief Expert of Pancreatic Cancer at Memorial Sloan Kettering (MSK) Cancer Research Center, showed that the tumor response index (TRI) was 100% sensitive and The specificity of 90.3% accurately predicted the response of 94.2% of pancreatic cancer patients to treatment; in contrast, the response rate of treatment prescribed by oncologists was only 40.4%.
Most patients with pancreatic cancer have multiple mutations, which lead to different drug resistance pathways in patients. Cunning cancer cells use these drug-resistant pathways to resist doctors’ treatment plans, resulting in lower treatment response rates.
Relying on computer biological simulation and artificial intelligence technology, TRI uses the patient’s entire exome information to create personalized disease models, conduct biological simulations, and analyze genome, proteome, transcriptome, and epigenome variation information on tumor cell signaling pathways. Downstream impact, and analyze specific drugs or drug combinations.
Therefore, it can predict the treatment response of the patient before receiving treatment, thereby reducing the risk and the ineffective cost of failed treatment, and helping to save lives. This is equivalent to a rigorous “sand table deduction” before treatment, so as to predict the best personalized medication plan for patients and provide clinicians with decision support based on molecular and genetic-level pathogenesis.
With the in-depth study of genomics, metabolism and tumor immune microenvironment, new therapeutic targets are constantly being discovered, and the research of related new drugs is also changing day by day, which is expected to change the dilemma of pancreatic cancer treatment.
(source:internet, reference only)