No matter who you are, pancreatic cancer can be one of the most difficult cancers to treat. Yet the Black community is more likely to develop aggressive pancreatic cancer than any other race or ethnicity.
While social determinants of health (including access to healthcare) are partly to blame, researchers at Henry Ford Health have uncovered possible contributing factors. They compared tumor differences between Black and white patients who had the most common type of pancreatic cancer, called ductal adenocarcinoma. They found that Black patients were more likely to overexpress a protein called PD-L1, which is a genetic mutation associated with cancer cells escaping the immune system’s watch. They were also more likely to have genetic mutations called TP53 and KRASG12R, which affect the speed and severity at which cancer grows.
“These findings are so important,” says Ling Huang, Ph.D., a researcher at Henry Ford Health who led the study. “Historically, there hasn’t been as much diversity in research and clinical trials. But our study proves we must take race into consideration, because people have different gene mutations that may influence how effective a treatment is.”
Precision Medicine in Pancreatic Cancer Treatment
Knowing someone has certain gene mutations means a treatment can be designed to specifically target them. This is called precision medicine, or medicine that’s tailored to the individual. For example: Immunotherapy is a type of cancer treatment that activates your own immune system to destroy cancer cells. When your immune system is functioning normally, PD-L1 works as a safeguard to prevent immune cells from attacking your own cells. When tumor cells overexpress PD-L1, your immune system is less efficient in recognizing and eliminating those tumor cells. An immunotherapy drug that blocks PD-L1 will partially restore immune cells’ functions to attack tumor cells.
Pancreatic Cancer Care At Henry Ford
“An immunotherapy drug that’s created to target PD-L1 won’t be effective for everyone,” says Dr. Huang. “But it will be more likely to work for those who overexpress PD-L1. This is why we need diversity in research and clinical trials – it will help us understand what treatments will be effective for which groups of people. We need to study diseases in patient populations that reflect the racial makeup of the United States.”
Increasing Diversity In Clinical Trials
Dr. Huang says doctors play an important role in increasing diversity in clinical trials. “Doctors are treating patients and they are the patients’ source of knowledge,” he says. “But researchers in the lab can help too; having our data published to show there’s a potential biological basis for increasing diversity in clinical trials. And then it’s about community outreach and establishing a relationship of trust between patients and doctors. I think we have a unique strength at Henry Ford Health, as we have a large minority population that we serve and have built a strong relationship with.”
Last but not least – if you are a patient, ask your doctor about the clinical trials you might qualify for. Clinical trials can not only help move research forward, but they can also potentially prolong someone’s life.
Reviewed by Ling Huang, Ph.D., a cancer researcher at Henry Ford Health.
