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

Li, Yuguo; Qiao, Yuan; Chen, Hanwei et al. (2018) Characterization of tumor vascular permeability using natural dextrans and CEST MRI. Magn Reson Med 79:1001-1009
Saung, May Tun; Muth, Stephen; Ding, Ding et al. (2018) Targeting myeloid-inflamed tumor with anti-CSF-1R antibody expands CD137+ effector T-cells in the murine model of pancreatic cancer. J Immunother Cancer 6:118
Canto, Marcia Irene; Almario, Jose Alejandro; Schulick, Richard D et al. (2018) Risk of Neoplastic Progression in Individuals at High Risk for Pancreatic Cancer Undergoing Long-term Surveillance. Gastroenterology 155:740-751.e2
Makohon-Moore, Alvin P; Matsukuma, Karen; Zhang, Ming et al. (2018) Precancerous neoplastic cells can move through the pancreatic ductal system. Nature 561:201-205
Chu, Nam; Salguero, Antonieta L; Liu, Albert Z et al. (2018) Akt Kinase Activation Mechanisms Revealed Using Protein Semisynthesis. Cell 174:897-907.e14
Felsenstein, Matthäus; Noë, Michaël; Masica, David L et al. (2018) IPMNs with co-occurring invasive cancers: neighbours but not always relatives. Gut 67:1652-1662
Grant, Robert C; Denroche, Robert E; Borgida, Ayelet et al. (2018) Exome-Wide Association Study of Pancreatic Cancer Risk. Gastroenterology 154:719-722.e3
Tie, Jeanne; Cohen, Joshua D; Wang, Yuxuan et al. (2018) Serial circulating tumour DNA analysis during multimodality treatment of locally advanced rectal cancer: a prospective biomarker study. Gut :
Adler, B L; Pezhouh, M K; Kim, A et al. (2018) Histopathological and immunophenotypic features of ipilimumab-associated colitis compared to ulcerative colitis. J Intern Med 283:568-577
Ma, Qianqian; Gabelli, Sandra B; Raben, Daniel M (2018) Diacylglycerol kinases: Relationship to other lipid kinases. Adv Biol Regul :

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