Pancreatic cancer continues to be one of the hardest cancers to treat, so as part of our Research Strategy, we’ve pledged to boost research in this area with the ultimate aim of improving patients’ survival.
Professor Nick Lemoine, Director of the Barts Cancer Institute, is a world-leading expert in pancreatic cancer and as part of our ongoing Expert Opinion series, he shares his vision for a future in which we can beat this disease.
Cancer Research UK: Why did you choose to focus on pancreatic cancer?
Nick Lemoine: It is a serious health problem across the western world and is becoming an increasing problem worldwide as we get more industrialised and people live longer.
Sadly, the 5-year survival rate hasn’t changed for the last 40 years, and that’s something that urgently needs addressing.
Cancer Research UK: What makes pancreatic cancer so difficult to treat?
Nick Lemoine: One significant problem with the pancreas is that it is deep within the body. You can’t see it, you can’t feel it and by the time symptoms or signs of the disease develop, surgery is no longer an option. And unfortunately, conventional chemotherapy drugs, which have largely been developed for other types of cancer, aren’t very effective, and neither is radiotherapy. So we need a new approach to the problem.
Cancer Research UK: What do you think the field needs in order to move forward?
Nick Lemoine: I think that there are two issues; firstly, we need to improve early diagnosis. This will increase the proportion of patients who could be cured by conventional approaches – largely surgery. And secondly, we need better treatments to offer patients at the other end of the spectrum for whom this is no longer an option.
Historically, pancreatic cancer hasn’t had a dedicated drug development programme – it has only received ‘hand-me-downs’ from other tumour types. But thankfully, this is beginning to change and it’s fantastic to know that Cancer Research UK is so committed to improving the outlook for pancreatic cancer patients.
Cancer Research UK: Could you tell us a bit about the work your lab is doing?
Nick Lemoine: My lab is interested in biomarkers for pancreatic cancer; these are molecules or genetic changes that we can measure, and that are specifically associated with pancreatic cancer. They will help us develop better ways to diagnose the disease earlier and will also provide targets for new therapies.
We study the genes and the molecules that drive the initiation and the development of cancer in the pancreas so that we can build a timeline that tells us which changes happen when. Then, we see if these changes can be detected in body fluids, particularly urine, but also potentially in blood, in order to pick up the disease at a stage when treatments have a better chance of working.
Cancer Research UK: How would you envision using this test?
Nick Lemoine: We know that pancreatic cancer becomes more common in people over the age of 60. But there are other risk factors. For instance, smokers have a moderately increased risk of pancreatic cancer. And pancreatitis is also a risk factor. This is long-standing inflammation of the pancreas which, in the UK, is largely due to excessive alcohol intake and also gallstones.
So if we can find markers that are associated with the very early stages of the disease, we might be able to use them to screen patients that we know are at an increased risk of pancreatic cancer.
Cancer Research UK: You mentioned that biomarkers for pancreatic cancer might also provide targets for therapies. How are you exploring this?
Nick Lemoine: Ours is a new approach; we’re developing gene therapy systems that are targeted against the very selective range of genetic abnormalities that affect pancreatic cancer specifically. And they’re different to those that are involved in other types of cancer. So we’re essentially turning the knowledge we’ve gained back on the problem to solve it. We’re using viruses that specifically target pancreatic cancer to deliver the gene therapy.
Cancer Research UK: Why did you decide to use viruses?
Nick Lemoine: Viruses have evolved to enter cells and deliver genes so we’re simply taking advantage of this. The viruses we’re using are found in nature but we’ve modified them so that they can only infect and multiply in cancer cells. We’re combining two viruses; they both work in different ways but cancers – particularly pancreatic cancers – can’t develop resistance against either.
We’ve found that this combination not only destroys the cancer but it also produces an enormously powerful and long lasting immunity against that cancer. So we can start thinking about treating the disease at a much earlier stage and vaccinating patients in a single shot – that’s extremely exciting!
Cancer Research UK: So what’s next?
Nick Lemoine: We recognise that one of the ways these viruses can work against cancer is by stimulating the immune system so we want to amplify that and direct it exclusively and more powerfully against the cancer. And so we’re looking at arming those viruses with particular genes that influence the way that the immune system behaves.
Once we’ve done all the testing and validation to make sure that it is safe and works the way we think it does, we plan to take it into clinical trials, hopefully over the next two or three years.
Cancer Research UK: What inspires you most about your job?
Nick Lemoine: I think that the real excitement for me is that I can bridge the divide between the lab and the clinic. So I spend half my day in the fantastic new Barts Cancer Centre overseeing the care of our patients and the other half in the laboratory developing new approaches that could change what we do in the hospital. And being able to see both sides of the spectrum is very exciting.
Interview conducted by Safia Danovi, September 2011
Dave February 25, 2012
My best friend died of this horrible form of Cancer. :(
I hope you find a cure soon!!
Jayne Coles November 2, 2011
My Mum had pancreatic cancer, she never touched a cigarette in her life and she never drank, she was very healthy and had a good diet, so why did it strike her down??
Simon Baker October 18, 2011
My Mum passed away due to Pancreatic Cancer this year (July 26th), she had no real symptoms until Spring this year, one day she had a terrible pain in her side, and that pain carried on for a while but she thought it was indegestion as it kept moving around her body, under her ribs, in her right shoulder, in her back, and it was always worse when she tried to lye down and it was almost impossible for her to sleep, she was diagnosed officially in July and she passed away the day after in Hospital, she was told she had cancer of the pancreas that had spread to the Liver and Lungs, it was such a shock to be told she only had hours left to live after only just being diagnosed.
She had terrible Jaundice and swelling in her feet, legs and ankles, she really did suffer and it was heartbreaking to watch her, she had never really had a days illness in her life. I wish Prof Lemoine the best of luck in his research and hopefully together we can win the battle! Simon.
Lizzie Owen October 13, 2011
Sylvia,I know exactly what you are saying Cliiff had the same awful itching as your friend,nothing bringing relief ,we tried everything but to no avail,just he being driven to a form of MADNESS and myself helpless to put an end to the constant torment.We sat,walked, talked nights after night,till exhaustion took over. Nobody knows, you can’t explain if you have not experienced this suffering.I endorse YOUR HOPE..!!!GODBLESS
Kat Arney October 14, 2011
Thanks for your comments everyone, and we’re very sorry to hear about the experiences you’ve been through with your loved ones. It’s stories like this that make us even more determined to beat cancer through research, by finding more effective and kinder treatments.
Lynn – although when we look at the population as a whole, pancreatic cancer is more common in older people, we agree with you that there’s a significant group that are diagnosed with the disease at a younger age. Being able to detect this cancer at an earlier stage could make a big difference to survival for people of all ages. We’re funding researchers like Dr John Timms at UCL, who’s developing new tests for the pancreatic cancer that could help to pick it up at an earlier stage: http://info.cancerresearchuk.org/cancerandresearch/ourcurrentresearch/researchbygrantee/dr-john-timms
Best wishes to you all,
Kat Arney, Science Communications Manager
Sylvia Mackay October 13, 2011
I hope that you can start your trials soon because this is a particularly frightening cancer to contract. Not only because it can be hidden for so long but the symptoms from anything to do with the pancreas are so uncomfortable for patients. My friend was driven potty with the itching all over her body, whilst also going through the agony of the pain from cancer. I am full of admiration for all the scientists in the research of cancer and really do think that even though I am not a scientist or a doctor that there is something in nature that will attack this fungus, that is the way I see cancer because the spaws travel just like a fungus and settle where they fall. Sorry for being so simplistic it ‘s the way I see it. Good Luck in your research Prof Lemoine.
Lizzie Owen October 12, 2011
My husband died of this dreadful disease in 2008 aged 64.He had always been very fit and active and had no medical problems at all except for a couple of days with a serious pain in his side,because this was so out of charater,I made him see our GP.blood tests were done and within a week he was severely jaundiced and admitted to hospital as a matter of urgency a week later we were told he was terminally ill and as far as could be predicted his life-span would be in the region of 4months !!!!! He was asked and accepted to be a research patient on the Metxia p450 gene therepy trial,that Prof. Neoptelemos and his team were conducting at the Royal Liverpool Hospital.It was a straw to cling to and he thought he would at least help for the longevity of future sufferers.I kept a diary of the whole year till Cliff died at home with all the family…a year after being diagnosed,but that was 8months more together than we were told we would have,so I Thank God for that…We will never know if it was the ground breaking treatment,that prolonged our time together, as he was just a Trial Number but in life he did his best for the future and I hope and pray Prof Nick Lemoine will have positive results with his team to help BEAT THIS SILENT KILLER xx
Lynn Buck October 12, 2011
My first husband died of pancreatic cancer in 2005 at the age of 56. Whilst enthusiastic about the upcoming developments against the disease from personal experience some of the facts are not completely accurate. I know of quite a large number of people (some very well, personally) who died of this and out of about twenty at least ninety percent were well under the age of sixty with some in their thirties and forties. I might add that most didn’t fit the profile of drinking/smoking. But whatever the facts the sooner an adequate diagnostic tool is found and subsequent treatment regime the better.
Katie McDonald October 12, 2011
My dad died of pancreatic cancer in 2000. His symptoms were dismissed time and time again, for over a year! By the time he was diagnosed it was too late. He deteriorated rapidly and it was terrifying to see a once vibrant, healthy man reduced to skin and bones. If there is any way that this dreadful illness can be detected earlier and dealt with before it is too late, I know that it can only be a good thing.