Pancreatic cancer is a “medical emergency” and must be treated as such if the situation for patients is to be improved, says J-Matthias Löhr. As professor of gastroenterology and hepatology at Sweden’s Karolinska Institutet, Löhr has direct experience in tackling what has been referred to as the world’s ‘greatest oncological challenge’.
“This is a threefold problem,” he says, first underlining the difficulties surrounding the identification of the disease. “Pancreatic cancer suffers from a very late diagnosis. This is not something on the skin and there is no easy access to this organ. Often jaundice caused by a blocked bile duct is the first sign. Of those who are diagnosed with pancreatic cancer only 22 per cent qualify for surgery compared with 80 per cent for colorectal. For those who do undergo an operation they typically live for another 24 months, while the vast majority of sufferers have only six to eight months.”
The second problem highlighted by Löhr is the lack of money available for pancreatic cancer. “In childhood leukaemia there is lots of money for research, but in pancreatic cancer there is a lack of survivors to raise awareness and campaign for funding.”
Pancreatic cancer needs an injection of funds in order to “develop new approaches that can help in earlier diagnosis”, he says. The third issue relates to research in improving outcomes. “We need more specific research programmes on pancreatic cancer,” stresses Löhr. “At the moment it is the ‘big indicators’ which get the money, which is shown by colorectal cancer receiving more grants than other types of cancer.” He highlights the technological improvements that are opening up possibilities for new treatments, saying, “Now that we can map the whole genome of a person we must look into developing targeted therapies that work on a cancer’s specific genes.” There must be more research into “tumour sequencing” if progress is to be made, says Löhr. “In the US the number of abstracts and studies that involve tumour profiling is increasing exponentially,” he adds, warning that “Europe is being left behind”. “We need research programmes which support this translational research in biomarkers and allow personalized cancer medicine. We must conduct these kinds of studies. It is possible to do this on a European level so Horizon 2020 is certainly a step forward, but I have also been a reviewer for European grants and there are far more being given out for other cancers.”
“There is a need for a paradigm shift,” says Löhr, who also points to a method of treatment called “off label use” where drugs approved for use in treating another disease are repurposed. This technique is increasingly being used in pancreatic cancer treatment as, currently, “there is nothing that is really working very well for this disease”. “To use this technique on a patient by patient basis and maybe even try drugs which have not been taken for this particular tumour, this is something which people will have to get used to.” “Unfortunately,” he says, “health insurance providers are not allowed to pay out for this kind of therapy.” Löhr concludes by calling on EU policymakers to “kick off a discussion” on how to improve the situation for pancreatic cancer. “The European parliament or commission should,” he says, “actively pursue a discussion from the EU level on how to change the landscape for healthcare providers and how to make these kinds of drugs available for personalised cancer medicine.”
J-Matthias Löhr is professor of gastroenterology
and hepatology and senior consultant at the
Karolinska Institutet
Source – “The Parliament Magazine, 12 November 2014”
2014-11-12-Pancreatic-cancer-supplement-FINAL.PDF
