Taking control of Pancreatic Cancer
When it comes to cancer treatment it is not a ‘one size fits all’. Just as every person has a fingerprint unique to them, every patient’s cancer has its own genetic fingerprint. The first step in optimising cancer treatment is to understand it.
Dr Gaya will organise a tumour analysis to uncover the unique genetic profile of the patient’s cancer. From here Dr Gaya can recommend – from the entire spectrum of conventional cancer treatments, newer advanced treatments, other medications, supplements and lifestyle modifications – to positively impact the patient’s quality of life and overall survival.
The treatment plan for each person can vary significantly depending on the type/stage of pancreatic cancer and also the overall health of the person undergoing treatment. This is because some treatments can be hard on the body and cause negative side effects. A fit and healthy patient is more likely to cope with intensive treatments. Dr Gaya advises his cancer patients on the possible impact of different treatments. For pancreatic cancer patients treatments include surgery, chemotherapy, radiation therapy, targeted therapy, immunotherapy and clinical trials.
Conventional Treatments
Advanced treatments
New treatments for cancer, including Pancreatic Cancer, are coming all the time. It is very important to have hope in fighting pancreatic cancer and having a world-leading oncologist, like Dr Andy Gaya, involved in your care is essential in navigating a new world of cancer care.
Targeted therapy refers to drug treatments which attack specific genetic mutations in tumours or specific chemicals in cancer cells. In theory, as they are more “specific” to cancer cells, they should cause less side effects. Unfortunately, almost all cancer treatments have some side effects.
Dr Gaya performs “molecular profiling” or “next generation sequencing (NGS)” on his Pancreatic Cancer patients to work out which mutations or chemical targets are present and which targeted therapies might be appropriate. There are relatively few drugs available and as such the number of Pancreatic Cancer patients with targetable genetic mutations is low (less than 20%). However, for the minority of patients there are increased treatment options (and these will increase rapidly in the next few years as KRAS inhibitors especially come to market).
For the majority of patients, where the genetic profiling that Dr Andy Gaya conducts on cancer tumours does not reveal a current targeted drug therapy, there may be research programmes available to them. Dr Andy Gaya has his finger on the pulse of the newest cancer drugs and can also provide information about Clinical Trials and identify appropriate enrolment of his patients.
Here are some examples of targeted therapies for some Pancreatic Cancer patients:
- KRAS mutations (KRAS inhibitors) – 90% of patients with pancreatic cancer have a mutation in the KRAS gene and 5% have a KRAS G12C mutation which some advanced drugs (like sotorasib and adagrasib) can target. More KRAS inhibitors are in development
- BRCA1 & 2 positive patients can receive PARP inhibitors, like Olaparib, for advanced disease after completion of chemotherapy. Up to 4% of pancreatic patients will be BRCA1/2 positive
- MMR (mismatch repair) deficient patients – can have immunotherapy treatment (Checkpoint inhibitors). 1% pancreatic cancer patients have this
Other mutations or fusions are quite rare in Pancreatic Cancer patients, such as BRAF, HER2, NRTK 1/2/3 and POLE, but important to discover as they can be effectively treated by a range of other drugs, like advanced immunotherapy drugs, traditionally used for other cancers.
