Pancreatic cancer priming may enhance response to chemo

Priming the pancreatic cancer environment by blocking molecules that cause tumour stiffness and growth may make cancer more responsive to chemotherapy, according to an Australian-led study.

Short-term focal adhesion kinase (FAK) inhibition enhanced PDAC gemcitabine/nab-paclitaxel (Abraxane) sensitivity in  pancreatic ductal adenocarcinoma (PDAC) models, researchers at the Garvan Institute of Medical Research showed.

Often hyperactivated and overexpressed in aggressive cancers, the nonreceptor tyrosine kinase, FAK, mediates bidirectional communication between cells and their environment. Inhibiting the enzyme prevents cancer-stroma interactions that promote matrix remodelling, induce tissue stiffness and accelerate cell proliferation, survival and disease progression, the authors wrote in Science Advances.

The inhibitor (FAKi) was particularly effective in models with reduced levels of the Merlin (NF2) tumour suppressor, which regulates cell surface receptor tyrosine kinase function and activity and modulates “outside-in” signalling to control contact-induced proliferation and tumour progression in various cancers. Therefore, Merlin could help identify patients most likely to benefit from short-term FAKi priming before chemotherapy and warrants further investigation, the authors wrote.

“Collectively this work demonstrates that short-term FAK inhibition improves chemotherapeutic efficiency in a subset of patients with PDAC and may be used to guide ongoing clinical trials involving FAK targeting in this highly aggressive and metastatic cancer,” they concluded.

Call to implement PROs in real world cancer care

Patient-reported outcomes are a powerful tool for precision oncology care, with the potential to predict treatment outcomes and improve medication adherence, an article in the Journal of Clinical Oncology says.

In women with breast cancer, PRO measurements were able to predict discontinuation of tamoxifen and thus identify women unable to tolerate treatment , a US study found.

PROs could therefore be tailored to specific patients and treatments to help identify problems and trigger specific interventions, according to a group of US oncologists.

However there are still significant barriers to extending symptom monitoring and analysis from the clinical trial setting to real world clinics, they acknowledged.

Cancer patients can’t survive on Jobseeker benefits

People with cancer are being forced into poverty and debt because they are deemed ineligible for the disability support pension even though they are unable to work, according to Cancer Council Australia.

A Senate Inquiry was told that patients diagnosed with cancer were struggling financially and socially as they lost their employment and had to try survive on Jobseeker payments that do not cover their additional treatment costs.

In a submission to the inquiry, the Cancer Council said Jobseeker criteria meant people with late stage cancers were required to attend Centrelink  every two weeks and look for work, despite being severely ill. They said there was a need for an income support system that met the unique needs of people with cancer who did not meet the DSP criteria of having completed treatment.

Patients said they felt they were being penalised for having cancer and were unable to survive on $250 a week when they had to pay for medications, tests and scans.