Vital Highlights 2014-2021

PERSONALISED SCREENING FOR

PANCREATIC CANCERS

In the era of personalized medicine , there is increased interest in identifying mutations in the DNA of tumours which signify that they are likely to respond to targeted therapy . One new class of drugs , known as RET - specific tyrosine kinase inhibitors , have shown dramatic effects on cancers , but only those rare cancers which harbour a specific type of DNA rearrangement in a gene called RET . As RET gene rearrangements are rare (< 1 % in all pancreatic carcinomas ) we do not currently have the resources to perform RET gene testing on every patient with pancreatic cancer . Dr Angela Chou and Professor Anthony Gill from the Cancer Diagnosis and Pathology group demonstrated that RET gene rearrangements are relatively common in a unique but rare subtype of pancreatic carcinoma known as acinar cell carcinoma ( at least 7 . 5 % of cases ) but occur rarely to never in other pancreatic carcinomas . Therefore rather than screening pancreatic cancers for this DNA mutation , only the acinar cell cancers ( less than 1 % of all pancreatic cancers ) need to be screened . This study , which can be found here , has proven that rather than performing expensive molecular testing on all patients with pancreatic carcinoma , we can perform the cheap and widely available specific test , FISH ( Fluorescence in situ hybridization ), only on the small subset of pancreatic cancers known as acinar cell carcinoma . FISH testing for RET gene rearrangements is now readily available for patients with pancreatic acinar cell carcinoma and , at the RNSH main campus , now considered standard of care .

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