Abstract

Over one million individuals are identified with pancreatic cysts every year. IPMNs and MCNs, are pre-cursors to pancreatic cancer, and offer the opportunity for the early detection, or even prevention, of pancreatic cancer. In contrast, serous cystadenomas or pseudocysts, are benign. Currently tools are inadequate to fully delineate these lesions prior to surgical resection, with up to 68% of the operations performed on patients with a pancreatic cyst ultimately found to be unnecessary. Guidelines recommend lifelong surveillance for IPMNs, however this is based on the lowest level of scientific evidence. Furthermore, no data exists on the molecular progression of IPMNs and MCNs in situ. We developed a Comprehensive Cyst (CompCyst) EUS companion test which combines clinical, radiological, genetic and protein marker data. In an initial evaluation of 862 surgically resected pancreatic cysts, the CompCyst test had a superior performance for identifying cysts which required surgery, needed surveillance, or were benign, compared with the current routine evaluation.
The Aims of the proposed project are to:
Aim 1 : Evaluate the genetic and clinical natural history of pancreatic cysts in a prospective international study.
Aim 2 : Evaluation and optimization of approaches for the management of pancreatic cysts.
Aim 3 : Develop a Second-Generation CompCyst test (CompCyst2). The overarching goal of Project 3 is to develop a clinically relevant tool which will be incorporated into clinical practice and will improve outcomes for patients with pancreatic cysts, specifically avoiding unnecessary surveillance or surgical resection.

Public Health Relevance

Pancreatic cysts are common and certain types can be precursors to invasive pancreatic cancer. Because of the risk of complications and death associated with either the under or over treatment of pancreatic cysts, better diagnostic methods for distinguishing pancreatic cyst type are required. The goal of this translational project is to develop a test that integrates clinical, imaging, molecular and protein data, to improve the management of pancreatic cysts, which will ultimately be used in clinical practice.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Specialized Center (P50)
Project #
5P50CA062924-26
Application #
10006164
Study Section
Special Emphasis Panel (ZCA1)
Project Start
1997-02-28
Project End
2023-08-31
Budget Start
2020-09-01
Budget End
2021-08-31
Support Year
26
Fiscal Year
2020
Total Cost
Indirect Cost

  Institution

Name
Johns Hopkins University
Department
Type
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21205

  Publications

Kuboki, Yuko; Fischer, Catherine G; Beleva Guthrie, Violeta et al. (2018) Single-cell sequencing defines genetic heterogeneity in pancreatic cancer precursor lesions. J Pathol :
Zhang, Jiajia; Quadri, Shafat; Wolfgang, Christopher L et al. (2018) New Development of Biomarkers for Gastrointestinal Cancers: From Neoplastic Cells to Tumor Microenvironment. Biomedicines 6:
Hata, Tatsuo; Suenaga, Masaya; Marchionni, Luigi et al. (2018) Genome-Wide Somatic Copy Number Alterations and Mutations in High-Grade Pancreatic Intraepithelial Neoplasia. Am J Pathol 188:1723-1733
Noë, Michaël; Rezaee, Neda; Asrani, Kaushal et al. (2018) Immunolabeling of Cleared Human Pancreata Provides Insights into Three-Dimensional Pancreatic Anatomy and Pathology. Am J Pathol 188:1530-1535
Schunke, Kathryn J; Rosati, Lauren M; Zahurak, Marianna et al. (2018) Long-term analysis of 2 prospective studies that incorporate mitomycin C into an adjuvant chemoradiation regimen for pancreatic and periampullary cancers. Adv Radiat Oncol 3:42-51
Zhang, Jiajia; Wolfgang, Christopher L; Zheng, Lei (2018) Precision Immuno-Oncology: Prospects of Individualized Immunotherapy for Pancreatic Cancer. Cancers (Basel) 10:
Dejea, Christine M; Fathi, Payam; Craig, John M et al. (2018) Patients with familial adenomatous polyposis harbor colonic biofilms containing tumorigenic bacteria. Science 359:592-597
Staedtke, Verena; Bai, Ren-Yuan; Kim, Kibem et al. (2018) Disruption of a self-amplifying catecholamine loop reduces cytokine release syndrome. Nature 564:273-277
Deng, Yang; Tu, Huakang; Pierzynski, Jeanne A et al. (2018) Determinants and prognostic value of quality of life in patients with pancreatic ductal adenocarcinoma. Eur J Cancer 92:20-32
Tamura, Koji; Yu, Jun; Hata, Tatsuo et al. (2018) Mutations in the pancreatic secretory enzymes CPA1 and CPB1 are associated with pancreatic cancer. Proc Natl Acad Sci U S A 115:4767-4772

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