Initial Clinical Target
Pancreatic Cancer: An unmet medical need
Pancreatic cancer is an aggressive form of cancer that develops in the cells of the pancreas. In 2019, an estimated 56,770 Americans (~30K men and 27K female) will be diagnosed with cancer of the pancreas, according to the American Cancer Society. Each year, pancreatic cancer accounts for about 3 percent of all new cancer diagnoses and more than 8 percent of all cancer deaths in the United States. The current 5-year overall survival rate is ~8%. Median survival is ~28 months in patients with resectable diseases although lack of methods for early detection limits the opportunities for surgical intervention.
The pancreas is a small organ that sits in the abdomen below the liver and behind the lower half of the stomach. The cells in the pancreas have two primary functions: Exocrine cells produce enzymes that help the body digest food, and endocrine glands produce hormones, including insulin, that help control blood sugar.
Pancreatic cancer occurs when cells in the pancreas develop mutations in their DNA. These mutations cause cells to grow uncontrollably and to continue living after normal cells would die. These accumulating cells can form a tumor. Untreated pancreatic cancer spreads to nearby organs and blood vessels. It is seldom detected in its early stages, but for people with pancreatic cysts or a family history of pancreatic cancer, some screening steps might help detect a problem early. One sign of pancreatic cancer is diabetes, especially when it occurs with weight loss, jaundice or pain in the upper abdomen that spreads to the back.
According to the American Cancer Society, for all stages of pancreatic cancer combined, the one-year relative survival rate is 20%, and the five-year rate is ~8%. These low survival rates are attributable to the fact that fewer than 20% of patients’ tumors are confined to the pancreas at the time of diagnosis; in most cases, the malignancy has already progressed to the point where surgical removal is impossible.
In those cases where resection can be performed, the average survival rate is 23 to 36 months. The overall five-year survival rate is about 10%, although this can rise as high as 20% to 35% if the tumor is removed completely and when cancer has not spread to lymph nodes. Tumor size does appear to impact survival rates. The larger the tumor, the less likely it is to be cured by resection. However, even large tumors may be removed and a number of patients with tumors greater than 4-5 cm appear to have been cured by surgery.
Current Standard of Care
Current standard of care results in low survival rates and high rates of harmful side effects. As such there is a significant unmet need for therapeutic options to increase overall survival and improve quality of life in this patient population. Current treatment includes surgery, chemotherapy, targeted therapy and radiation therapy. Oftentimes, combinations of these treatment options are used to treat with advanced patients.