A study led by Mayo Clinic has found that more than a cancer-causing gene is needed to trigger.
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The research team, led by Howard C. Crawford, Ph.D., a cancer biologist at Mayo Clinic’s campus in Florida, and Jens Siveke, M.D., at Technical University in Munich, Germany, found that for pancreatic cancer to form, mutated KRAS must recruit a second player: the epidermal growth factor receptor, or EGFR.A third genetic participant known as Trp53 makes pancreatic tumors very difficult to treat, the study showed.
The scientists also found that EGFR was required in pancreatic cancer initiated by pancreatic inflammation known as pancreatitis.
"We believe the perfect storm needed to trigger pancreatic cancer include KRAS mutations and inflammation in the organ, which then work synergistically to turn on EGFR," says Dr. Crawford.
"The bottom line is, without EGFR, tumors don’t form — and that was never known before this study," he says. "We also think that inflammation in the pancreas has a big impact on turning on EGFR."
The researchers discovered that when they blocked EGFR activity, the mice studied were protected against developing chronic pancreatitis and pancreatic cancer.
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Pancreatic cancer is a highly lethal disease; no drug has been able to target the mutant KRAS protein. The study suggests some patients, such as those with chronic pancreatitis, may be good candidates for treatment with EGFR inhibitors to fight or prevent pancreatic cancer, Dr. Crawford says.
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The EGFR inhibitor erlotinib is part of the standard therapy for pancreatic cancer patients, but has minimal effects in the patient population as a whole, he adds. "But that may be because many of the patients likely had a mutation in the TRP53 tumor suppressor, so erlotinib would not help them, since EGFR was no longer necessary for tumor growth.
"Perhaps erlotinib or other EGFR inhibitors would work much better in patients who do not have a TRP53 mutation," he says. "We also believe this kind of drug could prevent pancreatic cancer formation in patients with chronic pancreatitis, which is a significant risk factor for development of pancreatic tumors."
"These findings give us some greatly needed clues about how pancreatic cancer develops and progresses," Dr. Crawford says. "The more we understand about these early tumors, the more we will be able to work on diagnosis and therapy."
Source-Eurekalert