Precision oncology for pancreatic, biliary tract and ampullary cancers: strengthening molecular clinical trials with real-world patient cohorts from the Quebec Pancreas Cancer Study

Project goals:

To investigate the hereditary, onco-genomic and transcriptomic relatedness of pancreatic (PC), biliary tract (BTC), and ampullary (AC) adenocarcinomas.

Summary:

Pancreatic (PC), biliary tract (BTC), and ampullary (AC) adenocarcinomas are difficult-to-treat malignancies with 5-year survival rates of ~10%. When these cancers develop near the ampulla where the pancreatic and bile ducts join, their tissue of origin is often difficult to discern. We have hypothesized that PCs and BTCs map to a common cancer cell origin. Moreover, AC is classified into pancreaticobiliary or intestinal type, with the pancreaticobiliary type sharing histological and clinical features with PC and BTC. The biological relatedness of PC, BTC and AC provide a rationale to study these cancers together. Considering the rarity of these malignancies, integrative whole genome and transcriptome analysis of mature real-world cohorts will provide leverage to study hereditary risk for these related malignancies, and to interpret molecular tumour findings, treatment responses and survival outcomes towards discovering precision oncology and immunotherapy opportunities as well as mechanisms of therapy resistance.