Detailed genetic analysis of nearly 150 pancreatic tumours has given new clues about how the disease develops and spreads.

The research from Australia suggests that genes involved in nerve cell growth could have a role in the development of the disease, and opens the door to improving treatment of this notoriously hard-to-treat cancer.

Scientists from the University of Queensland and Sydney's Garvan Institute of Medical Research analysed the genetic faults in the pancreatic tumours of 142 patients.

The results, published in Nature, make up Australia's first report and contribution to the International Cancer Genome Consortium (ICGC) .

The consortium brings together the world's top scientists to catalogue the genetic faults in 50 different cancer types.

The survival rate for pancreatic cancer in the UK has more than doubled in the past 40 years, but fewer than one in five people survive their disease for more than a year.

Professor Sean Grimmond and Professor Andrew Biankin led the research. They and others analysed the genetic code of pancreatic tumours. These sequences were then compared with that of healthy tissue to identify the genetic changes involved in pancreatic cancer.

"This study demonstrates that so-called 'pancreatic cancer' is not one disease, but many. While tumours may look very similar under the microscope, genetic analysis reveals as many genetic variations in each tumour as there are patients," Professor Biankin said.

"As well as identifying 16 significant genes, we also identified a new pathway we think is important in pancreatic cancer. Called the 'axon guidance pathway', it normally regulates the way the brain and the nervous system develop. We don't know whether cancer has hijacked the same mechanisms or is using the same molecules to do different things."

The study could have implications for understanding the spread of pancreatic cancer as well as its treatment, according to Dr Thorsten Hagemann, a Cancer Research UK expert based at Barts Cancer Institute:

"Pancreatic cancer often spreads alongside the surrounding nerves, so it could be very significant that this team have found faults in genes involved in nerve cell growth in pancreatic tumours. One theory is that pancreatic cancer breaks out and spreads to other parts of the body along the nerve axons - this work could help us understand what is driving this spread.

"The faults in this pathway could also help to explain the pain people with pancreatic cancer often experience, as well as common symptoms of late-stage disease such as weakness and wasting of the body.

He said further work is needed, but "the possibility of future treatments that target this pathway is an exciting one, and this research also indicates that we could look for these gene faults to help predict which cancers are more likely to come back after surgery".

Cancer Research UK are leading ICGC projects in oesophageal and prostate cancer.

Source: CRUK