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Failure as a Route to Success

Credit: photopitu/adobe

Credit: photopitu/adobe

By Lorraine Chantrill

Lorraine Chantrill describes the obstacles that have impeded a clinical trial of genomically guided treatment of an aggressive form of cancer.

The full text of this article can be purchased from Informit.

Pancreatic cancer is expected to become the second most common cause of cancer death by 2030. This poor outcome is due to a constellation of factors: it is often undetectable when at an early stage and diagnosed late, it is a disease of older people, and it is aggressive, usually leading to death within a few months.

The only treatment that extends life expectancy when the disease is advanced is chemotherapy. Chemotherapy works on the premise that cancer cells are rapidly dividing; it does not exploit any differences between one cancer cell and another.

A key characteristic of pancreatic cancer that has impeded the development of new treatments is that there does not seem to be a common driver of cancer growth. Instead there are small subsets of patients with changes in their tumour genome that could benefit from targeted treatments that we currently use in other cancers.

We designed a trial to see if we could test a different approach to treating pancreatic cancer. Instead of treating all patients the same, we wanted to see if treating the cancer in an individualised way would be better.

This story tells the tale of the challenges we faced along the way and how difficult it is to implement a new way of approaching treatment in a disease that moves so quickly.

The pilot stage of the IMPaCT trial was a randomised trial that was designed...

The full text of this article can be purchased from Informit.