Pancreatic Cancer Therapeutics Overview:
In many medical centers around the world, research is underway for the identification of the causes, diagnosis, and treatment of pancreatic cancer. Here we have a look at what the latest developments are and what exactly have researchers got on their hands.
Early detection and genetics
Scientists are getting to know more regarding the changes in genes in cells of the pancreas which cause them to turn cancerous. BRCS2, p16 are some of the genes which undergo inherited changes and consequently increase the risk of a person developing pancreatic cancer. However, apart from being inherited, researchers are looking at the alteration of genes in pancreatic cancers which have not been inherited. It is a known fact that pancreatic cancer develops over a period of many years. During this time, it first develops itself as PanIN or Pancreatic Intraepithelial Neoplasia, during which changes take place in a small number of genes and ducts do not undergo abnormal changes. In the later stages of PanIN 2 and PanIN 3, several gene changes take place and abnormalities of duct cell appear evidently.
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The above information is being used by researchers for the development of specific tests for the detection of acquired gene changes in pre-cancerous conditions of cancer. Research has also shown that one of the most commonly affected gene changes in such pre-cancerous conditions involves the KRAS oncogene, which leads to changes in the regulation of cell growth. Currently, an imaging test such as ERCP, endoscopic ultrasound (EUS), and genetic tests for identifying changes in certain genes, are the foremost options for people who are having a strong family history of pancreatic cancer manifestation.
A lot of research is currently focused on the discovery of innovative treatments for pancreatic cancer, with the improvement of radiation therapy and improvement of surgery being the major goals. The determination of the best treatment combination for specific stages of cancer is also among the major goals of the latest research.
Surgery for the removal of the pancreatic cancer is quite a long and complicated procedure which is generally hard for both the patient and surgeon. Surgery requires a long hospital stay owing to the long incision made in the belly, which requires time to be healed.
The latest approach in surgery involves the performance of the surgical procedure laparoscopically, wherein several small incisions are made in the belly instead of the one large one, and the procedure involves the use of thin, long surgical tools with the insertion of a video camera through the cuts. The advantage of this surgery is that patients are able to recover faster, but the difficulty of the procedure is increased substantially.
Radiation Therapy – The latest developments in radiation therapy include intraoperative radiation therapy wherein a single large dose of radiation is provided to the area of cancer in the operating room at the time of surgery and proton beam radiation which involves the use of a special radiation type which might do less damage to the normal cells nearby.
Chemotherapy – Research is underway in many clinical trials for the testing of new chemotherapy drugs for pancreatic cancer. The latest studies are focusing on the combining ability of gemcitabine with other drugs to aid the people in living longer. Other newer chemotherapy drugs are also being tested, with research into their combinations as well.
Targeted drugs function in a different way than the standard chemotherapy drugs as they tend to attack only distinct target on cancerous cells. Targeted therapies might prove to be used alongside and in combination with the existing treatments. They have also been proven to have lesser side effects when compared to conventional chemo. The localization and increase in the efficiency of targeting is the most active area of undergoing cancer research.
These therapies are geared towards providing a boost to the immune system of the patient or to provide them with the components of an immune system to wage an attack on the cancerous cells. They involve the use of monoclonal antibodies, cancer vaccines, and drugs that target the checkpoints of immune systems.
Apart from the above, particular drugs tend to work better with certain types of mutations found in the tumor. For example, it has been seen that erlotinib might work better in patients having tumors with a change in the EGFR gene. Such areas have become hotspots of latest study and research. Further, there have been notable advances in the field of pancreatic neuroendocrine tumors (NETs). The pancreatic NETs have receptors for somatostatin on their cells which allows for their detection by imaging tests such as OctreoScan and also allows for their treatment with octreotide and other drugs. The latest forms of octreotide have further shown positive premises in the detection and treatment of NETs. These include the likes of Galliun-68 Dotatate and Lutetiun-177 Dotatate.