The past three decades have seen a rapid improvement of the ability of medical science to cure cancer. However, this ability depends greatly on the type cancer involved. Pancreatic cancer has the highest morality rate of all major cancers today. It is projected to be the 2nd most common cause of cancer deaths in the US by 2030. A whopping 93 percent of all pancreatic cancer patients will die within the five years following a diagnosis. It is one of very few cancers for which medical science has not become substantially better at treating in the last few decades.
The last few years have seen a number of groundbreaking medical discoveries, such as DNA sequencing and information technology advances. Now, a number of physicians are teaming up with theoretical physicists and other scientists to break through remaining obstacles such as the treatment of pancreatic cancer. This approach to scientific research is called convergence, which brings diverse scientific experts together to solve otherwise stubborn problems.
The team includes experts as disparate as Jeffrey Drebin, Chief of Surgery at Penn Medicine at University of Pennsylvania, and string theory expert Curtis Callan, who is a theoretical physicist at Princeton. In addition, the team includes an expert in the emerging field of immune-oncology, and a computational biologist.
The team is planning a clinical trial to prove that treatment-resistant pancreatic tumors can be made more vulnerable to patient’s immune systems using treatments of synthetic vitamin D.
One new factor in medicine is the increased availability of huge quantities of data about cells, proteins, genes, and other functions of the human body. While this data may hold answers to treating otherwise resistant cancer, very few physicians or biologists are trained for mining this data properly. Physicists, however, are well versed in making observations on very large (planetary) and very small (subatomic) scales.
One primary challenge in treating pancreatic cancer, which is often diagnosed too late for surgery, is penetrating the structure called a ‘stroma’ that surrounds the tumors. In the past few decades, strategies have focused on stripping away this barrier that forms around tumor cells, so that treatment such as chemotherapy can reach the tumors themselves.
Pancreatic tumors activate ‘stellate’ cells, cells which normally trigger a healing response to injuries. In the case of cancer, however, they can draw other cells into the area around the tumor, which can actually protect cancerous growth against chemotherapy.
Past research has shown that synthetic vitamin D can deactivate stellate cells in a petri dish, begging the question – could they disarm the tumor’s resistance to treatment and the immune system?
Another study found success using vitamin D to extend the lives of mice with pancreatic cancer.
However, the T cells of the immune system need special activation to destroy cancer cells. This adds to a number of other complex challenges involved in realizing the process. In the new convergence approach, these other scientists will help with the sequencing of patient’s DNA, their T cells, and their tumors. The computational challenges of these tasks are better suited to the work of scientists such as physicists.
The new trial will employ this method for pancreatic cancer patients who have qualified for surgery. Such collaborations are relatively rare in the world of science, and those involved are excited and optimistic to see the results.