Researchers at Detroit-based Karmanos Cancer Institute are harnessing robotic technology to accelerate the search for more effective pancreatic cancer treatments for pancreatic cancer, which has one of the highest mortality rates among all cancers.
Leading those efforts is Asfar Azmi, PhD, director of pancreas cancer research at Karmanos. His team is using the Opentrons OT-2 robotic system to test combinations of drugs on patient-derived tumor cells. The approach shortens discovery timelines and generates data that can inform treatment decisions in real time.
Dr. Azmi spoke with Becker’s about why he believes pancreatic cancer treatment is at a turning point and what hospitals need to do to prepare for a more personalized era of cancer care.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: How does the use of robotics change the pace of research? What might this mean for hospitals and health systems in terms of bringing new treatments to patients?
Dr. Asfar Azmi: Robotics is accelerating the process of research. With pancreatic cancer, molecular testing may reveal novel genes and we need to test which drugs work against them.
Previously, we screened hundreds of thousands of drugs manually, it was an extremely time-consuming process. It used to take weeks just to get a small number of promising results.
Now with robotics, machines that can screen hundreds of drugs in a single day. We place cancerous tumor cells on plates and treat them with many cancer drugs, including some used for other diseases that might affect those identified genes.
This converts the timeline from weeks or months into days. We can generate data that clinicians can review and determine whether certain drugs are worth trying.
For hospitals developing strategies to accelerate drug discovery or treatment, robotics is the way forward. Robotics can assist in drug testing, diagnosis, biomarker studies and correlative studies. All the manual work can now be automated, drastically cutting down timelines.
Q: Pancreatic cancer is the third-leading cause of cancer-related death in the U.S. What do you see as the biggest challenges today in pancreatic cancer detection, treatment and survival?
AA: A pancreatic cancer diagnosis can often be considered a death sentence, and there are many reasons for that.
Surgery is the only curative option so far, but that’s only for about 15% to 20% of patients. But the majority of patients are diagnosed too late to be eligible for surgery.
Pancreatic cancer is diagnosed very late because there are no early detection markers. Patients usually come with symptoms that overlap with other diseases, like back pain, jaundice and diabetes. By the time pancreatic cancer is caught, it’s already progressed and chemotherapy is the only option at that point. The two main regimens are toxic and can only improve survival for around eight to 11 months.
Historically, we’ve known about certain genes that are altered in pancreatic cancer, but we didn’t have drugs to target those genes. Now there’s new science emerging and we’re seeing some early signals in clinical trials that a new wave of personalized drugs may be more effective.
The more genomic and molecular testing that’s incorporated into hospital systems, the better. We won’t just catch the disease earlier, we’ll be able to treat it in a more personalized way. When I started my research, the five-year survival rate for pancreatic cancer was around 5%. Now it’s at 13%. The needle is slowly moving, but a lot more work still needs to be done.
Q: You’ve described genetic targeting as a “game-changer.” What role do you see large health systems playing in scaling these innovations so that more patients can benefit from these promising therapies?
AA: If you identify a mutation that has an associated drug, but that drug hasn’t been tested in pancreatic cancer, robotics lets us quickly screen it. Within days, we can tell doctors whether that drug appears to work. Then, they can make an informed decision about prescribing it to that patient.
They can decide whether to try the drug for that specific mutation. Robotics enables rapid, evidence-based decisions.
We’re at a turning point in pancreatic cancer research. We conduct comprehensive genomic testing on every patient that comes to our hospital in Michigan.
This profiling reveals mutations that may have existing treatments — such as those used in lung or colorectal cancer — but hadn’t been detected in pancreatic cancer before. We now know some pancreatic patients have those mutations and we provide targeted therapies.
Recently, we’ve made progress with one of the major drivers of pancreatic cancer: the KRAS mutation. This gene, found in about 90% of patients, was considered undruggable for years.
Through robotics and new technologies, KRAS inhibitors have been developed. Phase 3 trials are underway and we expect FDA approval in early 2026.
As genomic testing expands across hospitals, we’re moving toward personalized care becoming the norm. Patients will increasingly expect personalized treatment based on their tumor’s genetic profile. In time, chemo may become a secondary rather than primary option.
Q: Given pancreatic cancer’s historically poor prognosis, do you believe we’re at a turning point in how this disease is understood and managed? What signals are you seeing that the future may look different for patients and for the health systems caring for them?
AA: There are about 60,000 new pancreatic cancer cases annually, but around 55,000 people die, making incidence and death almost equal. For a long time, it was understudied, underfunded and somewhat ignored.
With breast cancer, for example, patients often survive and can advocate, fundraise or build organizations. With pancreatic cancer, if untreated, the survival is around four months. With chemo, it extends to six or eight, maybe 11 months. Patients don’t live long enough to advocate, which has made it harder to bring attention to the disease.
This is a major problem, and if we don’t focus on it now, we’ll lose ground. The good news is that progress is happening. Awareness is growing and I hope we can continue making a difference.
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