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| Mr Dan Croagh |
A collaborative research project including Monash Health
pancreatic surgeon Mr Dan Croagh and Hudson Institute of Medical Research
senior research fellow Professor Brendan Jenkins has been awarded a grant of
$51,500 from the CASS Foundation to improve clinical treatment of pancreatic
cancer.
Pancreatic
cancer, an inflammation-associated cancer, is the fourth most common cause of
cancer death worldwide, with an extremely low 5% five-year survival rate.
“Typically,
studies look at gene expression patterns between normal pancreas and cancerous
pancreas in order to identify unique signatures, which can be indicative of
sensitivity or resistance to specific chemotherapeutic treatments,” said
Professor Jenkins, Head, Cancer and Immune Signalling Laboratory, Centre for
Innate Immunity and Infectious Diseases.
“To
date, gene expression studies have largely focused on samples taken from open
surgical biopsy; a procedure known to be very invasive and only possible in 20%
of pancreatic cancers.”
Professor
Jenkins’ research group at the Hudson Institute, in collaboration with Mr
Daniel Croagh, Director of Research, Department of Upper Gastrointestinal and
Hepatobiliary Surgery at Monash Medical Centre, recently trialled an
alternative and less invasive process available to nearly all pancreatic cancer
patients known as endoscopic ultrasound-guided fine-needle aspirate (EUS-FNA).
“EUS-FNA
uses a thin, hollow needle to collect the samples of cells from which genetic
material can be extracted and analysed,” said Mr Croagh, who is also a senior
lecturer in the Department of Surgery, School of Clinical Sciences at
Monash University.
“Our
challenge is to ensure gene sequencing from EUS-FNA samples is comparable to
open surgical biopsy such that established analysis and treatment can be used.”
Results
from this study so far show that data from EUS-FNA-derived samples are of high
quality and also allow the identification of gene expression signatures between
normal and cancerous pancreas.
Professor
Jenkins’ group is now confident that EUS-FNA-derived material not only has the
potential to capture nearly all of pancreatic cancer patients (compared to ~20%
by surgery), but to also improve patient management and their treatment in the
clinic.
Professor Jenkins said that using next
generation gene sequencing, involving big instruments, big data and big
computing – allows near-term disruptive change in the clinical treatment of
pancreatic cancer.
“Next generation sequencing at
the Monash Health Translational Precinct (MHTP) Medical Genomics Facility will
be performed to identify candidate known and hitherto unknown cancer driver
genes via their altered gene expression (RNA) and/or mutational (DNA) status,”
added Professor Jenkins.
The clinical study, once
approved by ethics, will also be performed at Epworth under the leadership of
Mr Daniel Croagh using the resources from Epworth’s Clinical Research Centre.
“Upon
the successful completion of our study, the primary outcome will be laying the
foundation for the introduction into clinical practice of EUS-FNA as a standard
method of screening pancreatic cancer patients for molecular
"signatures" which can predict the responsiveness of individual
tumours to current therapies.”
Importantly, such signatures
could also provide novel molecular targets for future personalized
therapeutics.
“Our study highlights the
benefits provided by collaboration between clinician researchers and basic
scientists,” said Mr Croagh.
Ultimately, the research team
aims to increase the number of pancreatic cancer patients that respond to
personalized therapy, and therefore improve upon the overall poor 5-year
survival rate which has remained stagnant at 5% over the last few decades.
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