The Pancreatic Cancer Action Network’s “Know Your Tumor” program, initiated throughout the United States, uses a turn-key precision medicine platform developed by Perthera, Inc. that produces patient-tailored ranked treatment options through a decision support platform. In this activity, Dr. Emanuel F. Petricoin III describes how the program is making a difference in cancer care by delivering key information to oncologists and patients so they can collaborate to make the most appropriate tailored treatment decisions.
About the Program
The Pancreatic Cancer Action Network’s “Know Your Tumor” program delivers key information to oncologists and patients so that they can make the best therapeutic decisions at the most appropriate time. With the program, community and academic oncologists in any location within the United States and their patients gain access to patient- and tumor-specific precision medicine information that heretofore may have only been accessible in the highest-ranking, top-notch cancer centers.
One of the important benefits of the Know Your Tumor program is that it requires little action on the part of treating oncologists. Patients can initiate the process themselves or be referred to the program through their oncologists and then the Pancreatic Cancer Action Network and Perthera handle the rest of the heavy lifting.
The Know Your Tumor program ushers patients through a process that is simple and easy. In less than 30 days, treating oncologists and patients receive a patient-tailored report which ranks treatment options that are specifically tailored to the molecular genomic and proteomic characteristics of the patient’s tumor, hence the title of the program.
Promising Early Results
Data from the Know Your Tumor program were presented at ASCO 2018 after being initiated in 287 high-volume academic and local community practices covering 44 states. Nearly 1,000 pancreatic cancer patients in both urban and rural areas of the United States who received access to information from the program and had “highly actionable” molecular alterations experienced a three-fold increase in progression-free survival (PFS) after being matched to the top-ranked drug that was suggested by a Know Your Tumor report.
The significant impact on PFS seen with the Know Your Tumor program is likely just the tip of the iceberg. For example, an important but unexpected finding from our study was that nearly 30% of pancreatic cancer patients had a “highly actionable” finding. This means there is good evidence that a drug approved for breast, lung, or other cancers may also be beneficial for patients with pancreatic cancer because the medication works by altering similar molecular pathways. Matching the right drug to the right patient at the right time is the essence of precision medicine.
It has long been thought that most molecular changes in pancreatic cancer tumors were not clinically actionable. In our trial setting, with the advent of broad-scale and deep molecular profiling technologies, we helped map the architecture of the molecular landscape in pancreatic cancer. In fact, based on our findings to date from the Know Your Tumor program, we now know that a significant number of patients have tumors with highly actionable findings and we now have an opportunity to match pancreatic cancer patients to current FDA-approved therapies for other cancers, or experimental targeted therapies in clinical trials based on the molecular profile of their tumors.
A Path to More Treatments
A specific major finding from our study on the Know Your Tumor program was that a high percentage of pancreatic cancer patients with highly actionable findings had alterations in the DNA mismatch repair pathway. For example, a substantial percentage of pancreatic cancer patients with highly actionable alterations had a BRCA‑like fingerprint. These patients appear to be sensitive to PARP inhibitors, drugs that specifically target BRCA1 and BRCA2. In addition, a subset of pancreatic cancer patients—perhaps 10% or 15%—may be highly sensitive to medications currently approved for ovarian and breast cancer.
For community oncologists, it is critical to identify specific tumor alterations in pancreatic cancer and then treat them with currently available targeted therapies that are specifically designed for the tumor’s molecular alterations. The next step is to determine the significance of these alterations and how well they respond to treatment with specific therapies for other cancers.
The good news is our early results with the Know Your Tumor program suggest that some pancreatic cancer patients may live longer if they are directed toward receiving therapies that target specific molecular alterations. Considering the early success we have seen with the program, we anticipate more data on its impact at the ASCO 2019 Annual Meeting.
- Pancreatic Cancer Action Network. Know Your Tumor. Available at: https://www.pancan.org/facing-pancreatic-cancer/patient-services/know-your-tumor/. Accessed August 30, 2018.
- Petricoin E, Bender RJ, Halverson D, et al. Precision medicine for pancreatic cancer patients: preliminary results from the know your tumor program. ASCO 2018. Abstract 4126. Available at: https://meetinglibrary.asco.org/record/160147/abstract. Accessed August 13, 2018.
This activity is supported by educational grants from AstraZeneca, Celgene Corporation, Ipsen, and Merck & Co., Inc.