Pancreatic ductal adenocarcinoma (PDAC) is the most prevalent type of pancreatic cancer and is one of the deadliest human cancers, in part, due to its ability to metastasize. An unmet need in cancer research and for patients is to understand what makes PDAC metastasize, and to design new drugs that prevent or inhibit metastasis. No therapeutic agents are currently available (either FDA-approved or in clinical trials) that can target the unique biology that governs pancreatic cancer metastasis until now.
The biology of metastatic PDAC is distinct from that of the primary tumor. It is driven by epigenetic changes that govern changes in a cell without gene mutations or otherwise known as epithelial to mesenchymal transition (EMT). In numerous solid organ cancers, EMT drives tumor progression and metastasis but also resistance to cytotoxic therapies and immunotherapies.
Netrin-1 (also known as NTN1) is a key molecule in the development of the nervous system but it is upregulated in numerous solid organ cancers. Drs. Darren Carpizo and Igor Astsaturov have recently discovered NTN1 is a critical regulator of metastasis in PDAC. In metastatic PDAC models, their teams show anti-NTN1 methods suppress metastases and improve survival. They are conducting a pilot clinical trial with PDAC patients and a monoclonal antibody, NP137, shown to block EMT in models of varying cancer types and in patients with endometrial cancer.
The Carpizo and Astsaturov teams will measure circulating tumor cells (CTCs) from patients in the trial receiving the antibody NP137 to determine the EMT status before and after treatment and explore biomarkers of response to the antibody treatment.
Impact
Virtually ALL pancreatic cancer patients both late and early stage patients harbor disseminated disease, thus the potential impact of NP137 in pancreatic cancer is large. This is the first clinical trial of a therapeutic in pancreatic cancer that can putatively suppress metastasis and EMT. This research represents a unique opportunity to apply new technologies that can measure metastatic disease such as circulating tumor cells.





