Abstract 5071: The genomic landscape of pancreatic cancer: from discovery to patient care

Abstract

Abstract Pancreatic Cancer is the fourth leading cause of cancer death in our society, with a mortality that virtually parallels its incidence, a median survival of < 12 months even with maximal therapy, and a 5-year survival rate of < 5%. The diversity of clinical outcomes and the molecular heterogeneity of histopathologically similar cancer types, incomplete knowledge of the genomic aberrations that drive carcinogenesis and the lack of therapeutics that specifically target most known genomic aberrations necessitates large scale detailed analysis of cancer genomes to identify novel potential therapeutic strategies. As part of the International Cancer Genome Consortium (ICGC), the Australian Pancreatic Cancer Genome Initiative (APGI), together with the Baylor College of Medicine and the Ontario Institute of Cancer Research used exomic sequencing and copy number analysis to define genomic aberrations that characterise a large clinically focused prospectively accrued cohort of patients with pancreatic cancer (n = 142). The cohort consists of early (clinical stages I and II) non-pretreated patients with pancreatic ductal adenocarcinoma who underwent operative resection with curative intent. We devise approaches to adjust for low epithelial content in primary tumours and define the genomic landscape of pancreatic cancer to identify novel candidate driver genes and mechanisms. We develop stratified, molecular phenotype guided therapeutic strategies using existing therapeutics that are either rescued, repurposed, in development, or are known to be effective in an undefined subgroup of PC patients. These are then tested in primary patient derived xenografts and cell lines from the above deeply characterised cohort. In addition, we are launching a clinical trial named IMPaCT (Individualised Molecular Pancreatic Cancer Therapy). This trial randomises patients with metastatic disease to either standard first line therapy with gemcitabine, or a molecular phenotype guided approach using next generation sequencing strategies to screen for actionable mutations defined through the ICGC effort. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5071. doi:1538-7445.AM2012-5071