This application for a SPORE in gastrointestinal cancer addresses major issues of importance in pancreatic carcinoma. Pancreatic cancer affects approximately 27,000 Americans every year and the 5-year survival rate is approximately 2-3%. While some risk factors are known, we have little understanding of the early stages of oncogenesis in pancreatic adenocarcinoma. We currently have no effective clinical approaches to prevention or early detection. Our therapeutic interventions encompass surgery, radiation therapy, and chemotherapy. However, the majority of patients with this disease present with loco regional extension or metastases and are beyond hope of surgical cure. Chemotherapy and radiation have a primary role in the adjuvant therapy of this disease but has marginal impact on survival in-patients who cannot be resected for cure. This application focuses on prevention and early detection and on therapy. Three cores are designed both to support the existing projects and to build an important resource for future studies. These cores include Biostatistics, Tissue Bank, and the Pancrease Cancer Family Registry. The latter two cores will be of vital importance as a national resource in providing both normal and diseased pancreatic tissues for specialized studies and in providing a clinical resource for testing strategies that focus on prevention and early detection.
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