Episode 15 - Dr Eileen O'Reilly

So Eileen, you went back to Memorial and we could, I think... probably look at many of the years there is a time when there was more hope than fervent anticipation that there would be great advances in pancreas cancer.

But you stuck with it, worked your way at it, and suddenly it's come quite good in the last few years.

We've seen a few real improvements, real improvements already for real patients and ones that seem to hold great promise in the near future, not the far future.

I thought maybe for our audience, which, as you know, is a mixture of doctors and lay people, you might just say a little bit about what's happened in the pancreas field in the last few years.

Yes, thank you.

It's been extremely exciting times just to see this change and sort of this wave and I think just to sort of set the scene that this disease is one that we treat primarily with chemotherapy and that's been the mainstay for decades and it works, right? Chemotherapy has been shown to control cancers and people certainly live longer as a consequence of chemotherapy but no question it's been tough.

And pancreas cancer has not witnessed the developments and the successes of immunotherapy or of precision medicine relative to other diseases, just to look at lung cancer or to look at melanoma from the precision medicine or immunotherapy perspective, right? But what's been known for a long, long time is that there is a critical gene, Ras, that's switched on, that's basically a source of badness in this disease.

It's involved in growth, it's involved in spread of the cancer, and it's integral to the cancer itself.

And I think just looking at what happened, it was two main labs, and of many, there are many that are involved in this story.

But going back to 2013, an observation was made after many, many decades and lots of funded and amazing science to try to target RAS.

But there was an observation made that you could actually get something to stick on the surface of it.

which had been a problem.

It's kind of described as this greasy ball.

And that was in a very small subset of individuals who have pancreas cancer, a bigger subset of people who have colon and lung cancer.

And that sort of spurred the story.

And then I think there's been huge progress in terms of bioengineering, drug development, and also in terms of in a way, sort of the clinical trial kind of apparatus to facilitate this.

So the time was ripe in pancreas cancer, and it was very exciting to be in the clinic, to see these drugs being given to patients, and just to hear them feeling better in the setting of normally what we would consider as a very refractory disease setting, where the cancer was progressing and people were getting iller.

and sicker and they come in and they're starting to feel better and it wasn't one, it wasn't two, it wasn't three, it was many people.

And that sort of set the story that we're onto something big in pancreas cancer and just for what it means for us targeting in general.

And in a way, this story of duraxone massive, a new drug now that's FDA-approved in pancreas cancer, the clinical development of this started just a small number of years ago, and now a drug in the clinic.

Obviously, it can't be quick enough for patients and families with this need, but hopefully this is the accelerated pathway that's going to go from here.

Hopefully, and I can tell you that I was at your presentation, I guess, at AACR earlier in the year, and then there was the major presentation that you were the senior author on at the American Society of Clinical Oncology in June.

So the excitement has been palpable.

And the sense of urgency from patients, I've had more people, I don't primarily focus on pancreas cancer, but I've had more people contacting me to ask if I could use any offices I had to try and access the drug.

And it's been very difficult.