Investigators heading the project: Dr Manuel Hidalgo.
Centre where it is carried out:
Clínico San Carlos University Hospital (Dr Javier Sastre)
12 de Octubre University Hospital (Dr Rocío García Carbonero)
Ramón y Cajal University Hospital (Dr Carmen Guillen)
Fuenlabrada University Hospital (Dr Laura Medina)
Gregorio Marañón University Hospital (Dr Andrés Muñoz)
La Princesa University Hospital (Dr Ramón Colomer)
La Paz University Hospital (Dr Jaime Feliu)
Metastatic Pancreatic Ductal Adenocarcinoma is a very heterogeneous and aggressive tumour, with very poor prognosis and with increased incidence in the past few years. The survival rate is very low, being lower than 25% in the first year and 6.5% after five years. Usually, the diagnosis comes too late, as the tumour is generally detected when there has already been dissemination; in these conditions, on average the patient will have three months to live.
New therapies are needed urgently and, due to the heterogeneity of these kinds of tumours, it is extremely important to make advances in personalised therapies, to allow to treat each tumour according to its specific characteristics. The goal of the AVATAR Trial is to make a safety assessment and improve the survival rate of patients suffering from advanced pancreatic cancer who have been treated with chemotherapy but still have the disease.
This is a two-arm clinical trial: the control arm where patients are treated conventionally (the therapy they would receive if they had not been included in this trial) and another where a biopsy is performed on the patients. Part of this tissue is sequenced by means of Massive Sequencing techniques. This powerful technique allows not just to identify mutations in the tumour cells, but to distinguish different groups within the cells, and their abundance.
By identifying the specific alterations of each patient’s tumour cells, a bioinformatics analysis identifies a series of approved drugs that may be effective for each patient. The effectiveness of each treatment is assessed by implanting the biopsy tissue in immunodeficient mice, which will then develop the same tumour as the patient; finally, the team will decide what is the optimum treatment for the patient.
Achievements in the past year:
The initial project, the pilot trial financed by CRIS, has already been completed. Its results have provided the foundations for this much more ambitious project, which has deserved an Advanced Grant from the European Research Council, one of the most prestigious European projects. The current trial is a Stage III multicentre trial, with a target of 150 patients. It has already begun, and 19 patients have already been recruited.