Hanneke Wilmink was appointed Professor of Medical Oncology in 2021. She is a medical oncologist and researcher with expertise in pancreatic carcinoma. In her inaugural lecture on July 1, Prof. Wilmink discussed the progress made in the treatment and diagnosis of pancreatic cancer.
Collaboration
Prof. Wilmink was instrumental in founding the Dutch Pancreatic Cancer Group (DPCG), a multidisciplinary working group consisting of members from all disciplines involved in the treatment of pancreatic cancer, including surgeons, gastroenterologists, radiologists, radiotherapists, oncologists, pathologists, dieticians, nurses and also representatives of the patient association (Living with Hope). Much of the research in the Netherlands into pancreatic cancer is initiated by the DPCG and include studies that make use of existing data, for example from the Netherlands Cancer Registry. Their goal is to improve the care and survival rates of patients with pancreatic cancer.
Developments in treatment
In the last ten years, more and more patients became eligible for surgery and/or chemotherapy. New chemotherapy regimens have had a favorable effect on survival. “In addition, more attention is being paid to quality of life, with or without cancer treatment, for example through the platform for pancreatic cancer research, called PACAP (The Dutch Pancreatic Cancer Project),” says Prof. Wilmink.
Despite these advances, the average survival of patients with pancreatic cancer remains poor. There is therefore a great need for further development of better treatment options, says Prof. Wilmink. Patient research will always have to provide evidence of the effectiveness of a new treatment.
Smart trial designs
Prof. Wilmink believes that smart trial designs are needed to address the heterogeneity of the disease. “An interaction between tumor biology and clinical pathophysiology helps to design these studies efficiently and in a targeted manner. For this reason, linking translational research - whereby the results of a study are directly applicable in patient care - to clinical research is an absolute must,” says Prof. Wilmink. “For example, insight into the pathophysiology (the effects of a disease on the organs) can lead to the discovery of biomarkers that can predict toxicity of the treatment. In this way, you identify patients who will not benefit from the therapy and you also save unnecessary treatment costs - in other words - ‘personalized medicine’.”
Prof. Wilmink also sees that the feasibility of prospective phase III studies (studies with large groups of patients in which all data is gradually collected) is in jeopardy. This is due to the increasing subdivision of tumor types based on clinical and/or molecular properties into smaller and smaller subgroups. “This calls for more innovative designs for clinical research. An example is the trial within cohort design – or TwiCs - a research design in which observational cohorts, such as the PACAP cohort in pancreatic cancer, are used for randomized studies,” says Prof. Wilmink.
Delta Plan Pancreatic Cancer
“Of course, money is needed to make all this work and research possible. The Delta Plan for Pancreatic Cancer was set up a few years ago for this purpose,” says Prof. Wilmink. This is a national partnership of the Dutch Pancreatic Cancer Group, the patient organization Living With Hope and the Maag Lever Darm Foundation. With the Delta Plan for Pancreatic Cancer, promising and hopeful studies can be accelerated and implemented in daily practice. “The Delta Plan approach makes the Netherlands unique from an international point of view and therefore a model country for studies and rapid implementation of the latest national and international insights, treatment methods and approach. That is something we can be very proud of.”
For more information contact Prof. Hanneke Wilmink.
This was adapted from the article ‘Alvleesklierkanker: “Onderschat niet het effect van kleine stappen’.