Systemic Effects on Metastasis - a look beyond the tumor

forthcoming

What would you do if you were diagnosed with pancreatic cancer? The chance that it would happen is not that high (life-time risk of 1/60), but neither is the chance to survive (10%). In addition, the quality of life as a patient is severely compromised by inadequate understanding of the metastatic process, and lack of targeted treatment options or biomarkers to individualize treatment, leading to severe side-effects despite lack of treatment response in most cases. To make a difference and challenge this disease, by appreciating the systemic nature of cancer, I propose to focus on the role of the liver, the main organ of metastasis leading to subsequent death, in pancreatic cancer. I recently demonstrated the potential of using liver-derived information to predict outcomes in pancreatic cancer patients undergoing resection for localized disease (Bojmar et al., Nature Medicine, 2024). With this proposal, I suggest that the liver plays an active role in the progression of pancreatic cancer, and that this can be used to inform on treatment decisions, thereby improving the survival and quality of life in this patient group. I will investigate this concept through a translational study led by my team to evaluate treatment decisions guided by liver-based diagnostics, aiming at directing treatment locally or systemically, based on the metastatic biology of the cancer. Improving our knowledge about this stage of the disease could provide a treatment-window and open the door for tailoring chemo- and immuno-therapy, based on the systemic nature of the disease. I am uniquely positioned to lead this study, with my previous experience from the U.S., leading the first study of the human “pre-metastatic liver” in pancreatic cancer patients. Now independently established with my translational team and liver-based trials in the Swedish population, I aim to understand and tackle pancreatic cancer’s metastatic potential, thereby improving the life of afflicted patients.