The pancreas, which belongs to the digestive system, is a gland located behind the stomach that produces:

• pancreatic juice that neutralises the acidity of the alimentary bolus of the stomach and participates in the digestion of certain nutriments;
• insulin and glucagon, two hormones that regulate blood sugar.

Most of the time, cancer of pancreas is an adenocarcinoma. Often diagnosed very late, this tumour is hard to treat as it is located in a part of the body very difficult for surgical access, and it is relatively insensitive to chemotherapy.

Researchers at Inserm have recently discovered that it is the cells composing the fibrous casing of the tumour that decrease the efficacy of classical drugs and have obtained promising results through tests with an inhibitor of the signalling pathway responsible for the formation of this envelope, SOM203*.

*C. Duluc et al. Pharmacological targeting of the protein synthesis mTOR/4E-BP1 pathway in cancer-associated fibroblasts abrogates pancreatic tumour chemoresistance. EMBO Mol Med, Apr. 2015

A paradigm is a representation of the world, a way of seeing things, a coherent model of a vision of the world that relies on a defined basis (disciplinary matrix, theoretical model or school of thought).

It is like a rail on which thoughts run, but which can also be an obstacle to the introduction of new and better adapted solutions. A paradigm in the collective meaning is a system of widely held perceptions in a specific domain. That being said, paradigms tend to differ according to social group and change through time as knowledge evolves (particularly in the case of scientific paradigms).

For example, according to the site Devoir-de-Philosophie

Ptolemy (90-168), the author of an important treatise on astronomy, the Almagest (2nd century BC), proposed a geocentric model for the solar system that remained the accepted model from Antiquity to the Renaissance. Astronomers and mathematicians could work on the knowledge of celestial movements within this theoretical framework. Nevertheless, nonsensical observations were made – some planets did not appear to turn around the Earth – bringing this model into doubt. It was necessary to wait for Copernicus (1473-1523; On the Revolutions of the Heavenly Bodies, 1543), and above all Galileo (1564-1642; Dialogue concerning the two chief world systems, 1632), to establish a new scientific paradigm. The Copernican revolution consisted in putting forward the hypothesis that the Sun, and not the Earth, was the centre of the universe. So the Sun no longer revolved around the Earth, it was the Earth that revolved around the Sun. This heliocentric model constituted a change of paradigm.

The phenotype corresponds to the sum of the morphological, physiological and behavioural characteristics identifiable from the exterior. Thus two individuals can have the same genotype without having the same phenotype and vice-versa.

Pigmented villonodular synovitis is a rare disease affecting the joints, most often the knee though also the ankle and elbow. It is characterised by the tumefaction of the membrane producing the synovial fluid and brown nodules composed of iron pigments capable of penetrating the bone. This disease, assumed to be of cancerous origin of the family of soft tissue cancers, affecting young adults in particular, evolves slowly and generally does not spread. However it is complicated to treat and relapses are frequent.

A placebo is a product that appears exactly like a medicinal drug but which contains no active ingredient. In a clinical trial it is administered to each subject of the “control” group in the same way as the active drug studied in the “experimental” group. This makes it possible to evaluate the efficacy of the active ingredient more objectively.

Cellular plasticity refers to the capacity of cells to change identity and function (for example, a skin cell can become a neuron, etc.).

From embryonic development to the development of a cancer

Embryonic stem cells are capable of generating bone, skin, muscle and other types of cell, hence the term cellular “plasticity”. But the magic of life developing from a single cell which becomes a complete organism can also lead to the generation of fibroses and cancers. This highly specific property can also be used as an arm against cancer and degenerative diseases.

Embryonic stem cells are very plastic as they can be differentiated into several types of cells with different functions. Up to quite recently, adult stem cells, classically defined by their self-renewal properties and differentiation within certain tissues of post-natal recipients, were considered as being specific to the organ which they composed.

This notion was challenged by experiments demonstrating that grafts of certain tissues, especially bone marrow, in an animal having received a lethal dose of radiation, could generate not only haematopoietic cells (the cells at the origin of all blood cell lines) but also muscle, hepatic and even neuronal cells.

On the fundamental level, the discovery of the phenomenon of the persistence of stem cell “plasticity”, represents the overthrow of certain precepts, notably regarding the biology of stem cells and development in general.

As for applied research, these results could represent a major therapeutic breakthrough for several affections of interest to almost every area of medicine including neurology and oncology. However, many in vitro and in vivo studies will be necessary to determine whether this property of cells can result in the development of new treatments in human beings.

The preclinical stage in the development of a drug is also called “phase I”. It evaluates the activity and therapeutic effect of a substance on animal and/or cell models in the laboratory, following fundamental research and before trials on humans.

The data obtained from preclinical trials (action mechanism, toxicology, substance metabolism, etc.) are vital, from the scientific and regulatory standpoints, for continuing the development of a medicinal drug. They allow building the foundations of safe utilisation of the candidate drug during studies performed on humans.

The stage during which proof is obtained that a concept can have a functional application.

A proof of concept (POC) is a small scale demonstration that a certain method or idea is feasible. The proof of concept is usually considered to be an important step in the process of developing a fully functional prototype. For example, in the case of developing a drug, the candidate identified must have proven its efficiency during tests performed on cells taken from patients or on models representing the disease (e.g. a cell, animal, etc.)

In oncology, when a medical team decides to administer a drug treatment to a patient, the combination of anticancer compounds and its administration procedures are set out in a formal protocol. This document serves as the reference throughout the care given to the patient.

The protocol provides a precise description of the context of prescribing the drugs (essentially, the type of cancer involved), the drugs used with their dosage and their mode of administration (intravenous, oral), the treatment cycles (number of sessions, the period between them, the expected and observed toxicity, modifications to the treatment), and the duration of the treatment.
Generally, the protocol applied to the patient conforms to the protocol recommended by the experts for each type of cancer. These recommendations are based on studies that have proven the benefit/risk ratio of the therapy.