Wednesday, May 30, 2012

New Uses for Old Drugs to Treat Pancreatic Cancer

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s Focus On Pancreatic Cancer Conference. In this blog, she recaps the conference. You can view the conference in its entirety, including presentations here.

A Day of Cautious Optimism

"I have been to everyone of these pancreatic cancer conferences, and this is the most hopeful one yet."

These are the words of the wife of a six-year survivor of pancreatic cancer.  They speak to a genuine sense of cautious optimism that pervaded the annual Focus on Pancreatic Cancer Conference sponsored by Penn’s Abramson Cancer Center.  This new hope, grounded within innovative research, doesn't replace realism about the heavy toll pancreatic cancer takes and the persistently disappointing outcomes for most patients.  Patients, caregivers and physicians share an understanding that pancreatic cancer remains one of the most difficult forms of cancer to diagnose early and treat effectively. 

For the first time, though, there is real excitement about progress on a number of fronts, including better understanding of the biology and genetics of pancreatic cancer, improved technology for imaging and surgical interventions, and a more proactive approach to identifying individuals and families who are at increased risk of developing pancreatic cancer.  These aggressive approaches to diagnosing and treating pancreatic cancer are beginning to yield small, but real improvements in survival rates. 

Pancreatic cancer experts from all clinical disciplines discussed the promise of the future and the work under way at Penn to find better ways to diagnose and treat this disease to an audience of 200 patients and caregivers.

Innovative Research:  "Seeing Cancer Differently"

Starving Cancer Cells

Abramson Cancer Center Director, Chi Van Dang, MD, PhD, welcomed attendees, providing a short, clear primer on the complex biology of how pancreatic cancer cells grow, divide and invade neighboring tissue. The key to the future, he said, is "in seeing cancer differently." 

One key area of inquiry for pancreatic cancers is in studying the way these cells utilize energy – in effect what and how they feed themselves. The theory, Dr. Dang, explained, is that normal cells take in nutrients to divide, and then stop when the process is complete.  Cancer cells, on the other hand, are "addicted to nutrients," constantly gorging on them so that they can continue to grow and divide in an uncontrolled way.  They may also use different "food" than normal cells. 

One very exciting line of research is directed at this "addiction model" of pancreatic cells with the goal of basically starving cancer cells to death by depriving them of the nutrients they require.  The concept sounds simple, the implementation is far more complex, but the potential for developing targeted, metabolically based therapies is very real.

New Uses for Old Drugs

Most people think of new cancer treatments as developing new drugs. But in at least two cases, drugs that have been used to treat other conditions for many years are showing promise for treating pancreatic cancer. 

Led by researcher Peter O'Dwyer, MD, Penn is launching a clinical trial for cancer to test the efficacy of chloroquine, a drug used to treat malaria. Research has shown that chloroquine is highly effective in inhibiting what is known as autophagy, the ability of cells to replenish needed nutrients by eating themselves until they are able to find new sources of nutrition.  Pancreatic cancer cells are known to have a very high rate of autophagy and the hope is that chloroquine will stop that from happening and in the process slow down or stop the growth of the cancer. 

Metformin is another drug that is being "repurposed," finding new uses as an anti-cancer agent.  Metformin is traditionally used to treat diabetes.  It inhibits one step in the metabolic process and thus slows down the ability of cells to grow and divide. Like chloroquine, metformin is known to be safe.
Both of these drugs provide real hope for developing new therapies that will in effect cut the fuel line for pancreatic cancer cells.  In Dr. Van Dang's words, this research focuses on the "many differences between cancer cells and normal cells," differences that are becoming the basis for innovative clinical approaches to treating pancreatic cancers.

Learn more about pancreatic cancer clinical trials offered at the Abramson Cancer Center.

View the Focus On Pancreatic Cancer Conference to learn more about treatment options for pancreatic cancer at the Abramson Cancer Center.

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