Pancreatic cystic neoplasms are an increasing health problem in the adult population due to their inherent potential to progress to invasive adenocarcinomas. The only available treatment is surgical resection with the consequential significant morbidity and mortality associated with pancreatic surgery. Direct injection of an ablative substance represents a potential new approach to this problem. Limited studies performed in human subjects speak to the potential feasibility of this approach, but no systematic or rigorous assessment of agents and outcomes has been possible. We propose to study the effectiveness of intracystic injections of different ablative substances and chemotherapeutic drugs for the treatment of mucinous cystic neoplasms (MCN) in a genetically engineered murine model of the disease. Injections of a series of distinct chemical ablative regimens and conventional chemotherapies will be tested following cyst fluid aspiration. Disease response will be followed by high-resolution ultrasound and detailed histopathologic and molecular analyses will be performed on recovered tissues at study termination. The goal is to define the best therapeutic regimen for non-surgical management of MCNs for a future clinical trial.
Pancreatic mucinous cystic neoplasms (MCN) have the potential to become invasive adenocarcinomas which are the fourth leading cause of cancer deaths in the U.S. The only currently available curative therapy for MCNs is surgical resection which has a high morbidity and mortality. In the current proposal, we will systematically explore novel therapies for MCNs involving image guided aspiration and injection of ablative and chemotherapeutic agents.