MedicalResearch.com Interview with:
Nancy You, MD, MHSc, FACS
Department of Surgical Oncology
The University of Texas MD Anderson Cancer Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This study was motivated by the emerging promise of precision medicine and the emerging evidence that immunotherapy may have phenomenal efficacy in particular molecular subtypes of cancers. This specific molecular subtype shows deficiency in DNA mismatch repair mechanisms and therefore is thought to be more immunogenic. DNA mismatch repair deficiency can arise from germline defects such as in the case of patients with Lynch Syndrome, an inherited cancer syndrome, or from epigenetic inactivation DNA mismatch repair genes.
Overall, pancreas cancer has seen limited success with conventional chemotherapy. In our study, we demonstrated that there is a particular molecular subtype of pancreas cancer that is characterized by defect in DNA mismatch repair genes and by microsatelie instability that has a different prognosis than other pancreas cancers. This subtype of pancreas cancer is suspected to also respond to immunotherapy.
MedicalResearch.com: What should clinicians and patients take away from your report?
Response: Pancreas cancer should not be considered a cancer type with uniformly poor prognosis. By understanding the molecular subtypes of pancreas cancer, we could identify a subtype that is hallmarked by deficiency in DNA mismatch repair mechanism which shows excellent prognosis. Most of the patients in our series with this subtype of pancreas cancer also had Lynch Syndrome, an inherited germline defect that is responsible for deficiency in DNA mismatch repair. This study is an example of the promise of precision medicine.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future studies may include clinical trials that test the efficacy of immunotherapy for this specific molecular subtype of pancreas cancer.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Cloyd JM, Katz MHG, Wang H, Cuddy A, You YN. Clinical and Genetic Implications of DNA Mismatch Repair Deficiency in Patients With Pancreatic Ductal Adenocarcinoma . JAMA Surg. Published online August 09, 2017. doi:10.1001/jamasurg.2017.2631
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