Genetic Shape-Shifting Allows Pancreatic Cancer to Evade Treatment

A study published in Nature Genetics by NYU Langone Health reveals that pancreatic tumors are not static entities but dynamic collections of diverse clones. While previous research categorized pancreatic cancer into classical or basal subtypes, this granular analysis demonstrates that cancer cells actively reconfigure their DNA to shift between these forms. This adaptability explains why the disease remains notoriously difficult to treat, with a five-year survival rate of less than 15 percent.

The team identified the MYC gene as a primary driver of this aggressive transformation. Laboratory experiments confirmed that blocking MYC activity forced basal tumor cells to revert to a less aggressive classical state, simultaneously increasing their vulnerability to immune attacks. Furthermore, the researchers discovered that specific clones upregulate the TIGIT gene while suppressing PD1, a mechanism that likely renders current PD1-targeting immunotherapies ineffective for many patients.

Lead investigator Despoina Kalfakakou and co-senior investigator Aristotelis Tsirigos suggest that these findings provide a roadmap for future clinical interventions. By targeting the specific evolutionary mechanisms—such as MYC and TIGIT—that fuel tumor progression, clinicians may eventually be able to restrain the disease's rapid spread. Clinical trials exploring these targeted inhibitors are currently underway, marking a shift toward personalized, evolution-based cancer management.