2025 New Treatment Accelerator - Dr. Belinda Lee

The presence of tumour DNA in the blood (also known as circulating tumour DNA,  ctDNA) has been shown to be a power predictor of cancer recurrence. In an earlier  study, DYNAMIC-Pancreas trial, our team showed that 41% of pancreatic cancer  patients still had evidence of tumour DNA in the blood even after completing curative  surgery. The presence of residual tumour DNA in the blood led to the recurrence of the  pancreatic cancer within 13 months of their surgery in most cases. Patients with none  or lower levels of tumour DNA in the blood had better and longer survival outcomes  than those where tumour DNA was detected in the blood after surgery and/ or after the  completion of post-surgery chemotherapy treatments. To address this problem, we are  proposing a new clinical trial called the DISCOVERY-P trial. 

The DISCOVERY-P clinical trial will use the existing PURPLE pancreatic cancer registry  platform combined with this new strategy and blood test to detect tiny amounts of  tumour DNA in the blood after patients have completed curative surgery for pancreatic  cancer. This study will investigate if changing treatment based on the detection of these  tiny amounts of tumour DNA in the blood can inform treatment management and  improve survival outcomes for patients with pancreatic cancer following surgery. 

This new treatment strategy looking for tiny amounts of tumour DNA in the blood is also  known as minimal residual disease (MRD). Using this new technology and blood test to  detect for tumour in the blood (circulating tumour DNA, ctDNA) and treating patients  based on the MRD levels in the blood has the potential to guide treatment selection  more accurately and to accelerate the evaluation of new drug treatments for pancreatic  cancer.