Towards personalized medicine for pancreatic cancer

The PancreasView signature

In the management of pancreatic cancer, treatment with FOLFIRINOX chemotherapy, although effective, is associated with toxicities and reserved for patients who can tolerate this molecule. The choice of this chemotherapy is therefore currently based on the general condition of patients, rather than on cancer biology.

Researchers at the Cancer Research Center of Marseille (AMU/Inserm/CNRS/Institut Paoli Calmettes), in collaboration with clinicians at the Institut Paoli-Calmettes, have identified a signature, based on the molecular characteristics of the tumor and developed with the help of artificial intelligence, which predicts sensitivity to the various molecules used in pancreatic cancer. This work was awarded the Unicancer Prize for Research and Innovation in 2023.

This signature called PancreasView was tested for validation on 343 patients included in the PRODIGE-24/CCTG PA6 study, promoted by Unicancer, and with available biological material. The results showed that this signature made it possible to identify patients sensitive to the molecules under study. Patients who received appropriate therapy (m FOLFIRINOX or gemcitabine) showed improved survival. The use of these signatures in patient management could improve efficacy and reduce toxicity by avoiding unnecessary administration of drugs predicted to be ineffective.

" The results of this study underline the importance of the PancreasView molecular signature in identifying patients who respond favorably to treatment. This advance not only improves the survival of patients who receive appropriate therapy, but also considerably reduces the risk of associated toxicity. This breakthrough marks the beginning of a new era in pancreatic cancer management, where every patient can benefit from personalized treatment," says Dr. Dusetti.

About pancreatic cancer and the PRODIGE 24 study

Pancreatic ductal adenocarcinoma, the most common form of pancreatic cancer, is a particularly aggressive disease, the incidence of which has been rising sharply in recent years. Surgery is currently the only chance of cure, but is only possible in around 15% of patients, and metastatic relapse is unfortunately frequent. The use of adjuvant chemotherapy has significantly improved patient survival over the past 20 years. In 2018, the results of the PRODIGE-24/CCTG PA6 clinical trial, conducted in 493 patients in France and Canada, were presented. Promoted by Unicancer with the collaboration of the Canadian Cancer Trials Group (CCTG), and funded in France by the Ministry of Health and the Ligue nationale contre le cancer, this study showed a significant improvement in survival, with median overall survival increasing from 3 years to 4.5 years in patients treated with mFOLFIRINOX (trichimiotherapy based on 5-fluorouracil, irinotecan and oxaliplatin) compared with gemcitabine alone.