Luis Rios, a 66-year-old diagnosed with stage IV pancreatic cancer in 2017, has experienced a remarkable recovery after treatment guided by genetic testing that revealed a rare RAD51C mutation. His journey underscores the potential of personalized medicine in overcoming the challenges of pancreatic cancer, a disease with historically poor prognosis.
Diagnosis and Initial Treatment
Rios initially presented with vague symptoms, including acidity and indigestion, eventually leading to a diagnosis of stage IV pancreatic cancer. Following the diagnosis, Rios and his family sought expert opinions, which led them to Dr. Peter Hosein at Sylvester Comprehensive Cancer Center in Miami. Dr. Hosein, a member of PanCAN’s Scientific and Medical Advisory Board, adopted a novel approach to Rios's treatment.
Know Your Tumor and the RAD51C Mutation
Crucially, Rios enrolled in PanCAN’s Know Your Tumor program, which provides genetic and biomarker testing. This testing revealed that Rios carried an inherited mutation in the RAD51C gene, a mutation present in less than 1% of pancreatic cancer patients. This discovery was pivotal in tailoring his treatment.
Treatment Strategy and Unexpected Success
Dr. Hosein initially treated Rios with FOLFIRINOX chemotherapy for eight months, which Rios tolerated well. Following a positive response, Rios participated in a clinical trial targeting his specific genetic profile. However, after a year, the cancer began to progress, and subsequent chemotherapy regimens proved ineffective.
Given emerging research suggesting the potential benefit of immunotherapy in patients with BRCA mutations (which share characteristics with RAD51C mutations), Dr. Hosein proposed an off-label immunotherapy combination. This combination, though not previously used in pancreatic cancer, led to a dramatic turnaround in Rios’s health.
"The results were dramatic," Rios stated. "From the very first infusion, I started to feel way better... The scans were just incredible, the way everything shrunk."
Implications for Pancreatic Cancer Research
Rios’s case has spurred further research into the role of immunotherapy in pancreatic cancer. Dr. Hosein and his team are now investigating the mechanisms by which immunotherapy is effective in patients with RAD51C mutations, with the goal of extending these benefits to a broader population of pancreatic cancer patients.
"Luis’ case and a few other cases like that have given us a lot of optimism for being able to break through with immunotherapy in pancreas cancer," Dr. Hosein explained. He emphasized that while immunotherapy has not been generally considered effective in pancreatic cancer, these cases demonstrate its potential in specific genetic contexts.
Future Directions
Dr. Hosein's research aims to understand how immunotherapy works for this population to see if they can apply that to more patients outside of patients with these mutations. He also highlighted PanCAN’s role in supporting research and providing resources to patients.
With the five-year survival rate for pancreatic cancer now at 13%, Rios remains optimistic about the future, stating, "I have no doubt whatsoever that we’re turning the corner...thank God we are making the progress that we are."
