The complexity, and difficulty in treating, pancreatic cancer lies in great variety of its cells which present different morphological characteristics. Scholars put it this way: it’s like fighting against many different enemies. How to target them in a targeted and effective way? So how can we treat patients who fall ill with this pathology? There is a research who managed to explain some fundamental mechanisms at the origin of pancreatic cancer and who, thanks to artificial intelligence, understood that mixes of multiple and very precise therapies can be created. The discovery is due to the research group of the European Institute of Oncology coordinated by Gioacchino Natoli and Giuseppe Diaferia, with the collaboration of researchers from Ifom (the Institute of Molecular Oncology of the Airc Foundation) and the Division of Pancreatic Surgery of Humanitas.
This research indicates the possibility of innovative therapeutic approaches for one of the most difficult tumors to treat. The results of the research, supported by the Airc Foundation and the Ministry of Health, are published in the prestigious magazine ‘Cancer Cell’.
«Our research has revealed the intricate landscape of pancreatic cancer, clarifying its complexities and highlighting the challenges that persist for its effective treatment. In summary we have identified and characterized in detail – explains Natoli – the profound heterogeneity of each single pancreatic carcinoma analyzed. Precisely this heterogeneity contributes substantially to the ineffectiveness of existing treatments».
Pancreatic cancer: it will become the second leading cause of cancer death by 2030
Pancreatic cancer is predicted to become the second leading cause of cancer death worldwide by 2030 and already today there is an alarming lack of improvement in survival rateswhich have remained substantially unchanged over the last fifty years (ten years).
«Coexistence in every pancreatic cancer of populations of tumor cells with different morphological characteristics, i.e. with a different appearance and organization, has been known for some time. However, it has never been possible to establish the impact of this heterogeneity on the treatment of the disease – underlines Diaferia – We have used innovative technologies to the targeted isolation of small groups of tumor cells and for their molecular profilingand combined them with computational analyzes and artificial intelligence approaches. We have thus managed to define this heterogeneity, so that it can become the target of targeted therapies».
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How pancreatic cancer and its cells, which are so different from each other, are attacked
«It’s as if we were fighting multiple opponents at the same time, rather than against a single tumor – adds Pierluigi Di Chiaro, first author of the article – The different cellular conditions that develop dynamically within pancreatic carcinomas require combined and targeted treatment strategies, capable of intercepting all the populations of neoplastic cells that make up each individual tumor. Our work lays the foundations for the identification of these components and the definition of new strategies.”
The role of nerves as a pathway for metastasis
«One of the main results of the study concerns the invasion of nerves, which constitute real low-resistance escape routes for pancreatic cancer cells. In practice, nerves are the main route of metastatic dissemination, as well as the cause of the severe pain associated with this disease», warns Lucia Nacci, one of the co-authors of the article.
The researchers observed a clear correlation between the activation of specific gene expression programs and nerve invasion, also revealing potential mechanisms for therapeutic interventions. Finally, the demonstration of the link between the variety of morphological aspects and the different functional properties of tumor cells lays the foundations for the development of artificial intelligence approaches. These new tools could help analyze normal histological preparations – highlights the study – helping to establish the composition of the tumor and guide the doctor in choosing the most appropriate combination of drugs for each patient.
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«Understanding the heterogeneity of pancreatic cancer is crucial for developing effective therapeutic strategies – concludes Natoli – Even if this work is the fruit of years of technological optimizations and conceptual advances, it is only a starting point for new research that can pave the way to targeted therapeutic approaches that will finally offer new hopes for patients facing this difficult disease».
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