Early Detection and Risk Factors

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Publications investigating improved detection, diagnostic or prognostic markers or imaging techniques as well as factors influencing a person’s risk of developing pancreatic cancer.


Detection and Localization of Surgically Resectable Cancers with a Multi-Analyte Blood Test
PanCAN articles: Can a Blood Test Lead to Early Detection? and 6 Things to Know about the CancerSEEK Test and Early Detection
Institution(s): Johns Hopkins University School of Medicine, Baltimore, MD, and others
Corresponding author(s): Cristian Tomasetti, Anne Marie Lennon, Kenneth W. Kinzler, Bert Vogelstein or Nickolas Papadopoulos
PanCAN-affiliated authors: Ralph Hruban, Michael Goggins, Alison Klein and Samir Hanash
Major finding: Here the authors describe a blood test that can detect eight common cancer types through assessment of the levels of circulating proteins and mutations in cell-free DNA.

Genome-wide Meta-Analysis Identifies Five New Susceptibility Loci for Pancreatic Cancer
JournalNature Communications
Institution(s): Johns Hopkins University School of Medicine, Baltimore, MD, and others
Corresponding author(s): Alison Klein or Laufey Amundadottir
PanCAN-affiliated authors: Alison Klein, Brian Wolpin, Michael Goggins and Gloria Petersen
Major finding: To identify common susceptibility alleles, the authors performed the largest pancreatic cancer GWAS to date, including 9040 patients and 12,496 controls of European ancestry from the Pancreatic Cancer Cohort Consortium (PanScan) and the Pancreatic Cancer Case-Control Consortium (PanC4).

IPMNs with Co-Occurring Invasive Cancers: Neighbours but Not Always Relatives
PanCAN article: When Characterizing Cysts, You Should Look at the Entire Pancreas, Experts Say
Institution(s): Johns Hopkins University School of Medicine, Baltimore, MD, and others
Corresponding author(s): Laura Wood
PanCAN-affiliated author: Michael Goggins
Major finding: This study demonstrates a higher prevalence of likely independent co-occurring intraductal papillary mucinous neoplasms (IPMN) and ductal adenocarcinoma than previously appreciated. These findings have important implications for molecular risk stratification of patients with IPMN.

Progression Patterns in the Remnant Pancreas after Resection of Non-Invasive or Micro-Invasive Intraductal Papillary Mucinous Neoplasms (IPMN)
JournalAnnals of Surgical Oncology
Institution(s): Memorial Sloan Kettering Cancer Center, New York, NY, and others
Corresponding author(s): Peter Allen
Major finding: In this study, 22% of patients had disease progression following resection of noninvasive or microinvasive intraductal papillary mucinous neoplasms (IPMN); 16% of these progressions represented invasive disease. These patients represent a high-risk group and should undergo long-term radiographic surveillance.

Prospective Evaluation of Germline Alterations in Patients With Exocrine Pancreatic Neoplasms
JournalJournal of the National Cancer Institute 
Institution(s): Memorial Sloan Kettering Cancer Center, New York, NY, and others
Corresponding author(s): Eileen O’Reilly
PanCAN-affiliated authors: Steven Leach, Christine Iacobuzio-Donahue and Eileen O’Reilly
Major finding: Pathogenic germline alterations (PGAs) frequently occur in pancreas exocrine neoplasms and involve multiple genes beyond those previously associated with hereditary pancreatic cancer. These PGAs are therapeutically actionable in about 5% to 10% of patients. These data support routinely offering germline testing in all pancreatic ductal adenocarcinoma patients with a broad panel of known hereditary cancer predisposition genes.

An Integrated Flow Cytometry-Based Platform for Isolation and Molecular Characterization of Circulating Tumor Single Cells and Clusters
JournalScientific Reports 
Institution(s): University of Pennsylvania, Philadelphia, PA, and others
Corresponding author(s): Erica Carpenter
PanCAN-affiliated authors: Ben Stanger and Erica Carpenter
Major finding: As proof of principle, the authors isolated and transcriptionally characterized 63 single circulating tumor cells (CTCs) from a genetically engineered pancreatic cancer mouse model (n = 12 mice) and, using index sorting, were able to identify distinct epithelial and mesenchymal sub-populations based on linked single cell protein and gene expression.

Early Detection of Pancreatic Cancer: The Role of Depression and Anxiety as a Precursor for Disease
Institution(s): Kenner Family Research Fund, New York, NY
Corresponding author(s): Barbara Kenner
Major finding: This editorial addresses the role of depression and anxiety as a precursor to cancer and encourages further research on both the biomarker and mental health aspect of pancreatic cancer.

Determinants and Prognostic Value of Quality of Life in Patients with Pancreatic Ductal Adenocarcinoma
PanCAN article: Study Shows Quality of Life Impacts Survival
JournalEuropean Journal of Cancer
Institution(s): The University of Texas MD Anderson Cancer Center, Houston, TX, and others
Corresponding author(s): Xifeng Wu
PanCAN-affiliated authors: Alison Klein
Major finding: Quality of life (QOL) after diagnosis is a significant prognostic indicator for patients with pancreatic ductal adenocarcinoma (PDAC). Multiple factors determine QOL, suggesting possible means of intervention to improve QOL and outcomes of PDAC patients.

A Sub-Type of Familial Pancreatic Cancer: Evidence and Implications of Loss-of-Function Polymorphisms in Indoleamine-2,3-Dioxygenase-2
JournalJournal of the American College of Surgeons
Institution(s): Thomas Jefferson University, Philadelphia, PA
Corresponding author(s): Jonathan Brody
PanCAN-affiliated authors: Jonathan Brody
Major finding: The authors’ preliminary data suggest a strong association between the IDO2 inactivating Y359Stop SNP and an increased risk of familial pancreatic cancer when compared with the control group. Future studies will evaluate the value of IDO2 genotyping as a prognostic, early detection marker for pancreatic ductal adenocarcinoma and a predictive marker for novel immune checkpoint therapies.

Pancreatic Juice Mutation Concentrations Can Help Predict the Grade of Dysplasia in Patients Undergoing Pancreatic Surveillance
JournalClinical Cancer Research
Institution(s): Johns Hopkins University School of Medicine, Baltimore, MD
Corresponding author(s): Michael Goggins
PanCAN-affiliated authors: Marcia Canto and Michael Goggins
Major finding: Pancreatic juice mutation analysis using digital next-generation sequencing (NGS) has potential diagnostic utility in the evaluation of patients undergoing pancreatic surveillance.

Opium Use and Risk of Pancreatic Cancer: A Prospective Cohort Study
JournalCancer Epidemiology, Biomarkers & Prevention
Institution(s): Tehran University of Medical Sciences, Tehran, Iran., and others
Corresponding author(s): Reza Malekzadeh
Major finding: The authors examined the association between opium consumption and pancreatic cancer incidence in a large-scale prospective cohort of the general population in northeastern Iran. Their results showed a positive association between opium consumption and pancreatic cancer.

Association of VHL Genotype With Pancreatic Neuroendocrine Tumor Phenotype in Patients With von Hippel–Lindau Disease
JournalJAMA Oncology
Institution(s): National Cancer Institute, National Institutes of Health, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, and others
Corresponding author(s): Electron Kebebew
Major finding: The authors conducted a prospective study (NCT00062166) to evaluate the natural history of Von Hippel–Lindau (VHL) disease–associated pancreatic lesions to determine what factors were associated with pancreatic neuroendocrine tumor phenotype and prognosis.

Lifetime and Baseline Alcohol Intakes and Risk of Pancreatic Cancer in the European Prospective Investigation into Cancer and Nutrition Study
JournalInternational Journal of Cancer
Institution(s): International Agency for Research on Cancer, Lyon, France, and others
Corresponding author(s): Pietro Ferrari
Major finding: Findings from a large prospective study suggest that baseline and lifetime alcohol intakes were positively associated with pancreatic cancer risk, with more apparent risk estimates for beer and spirits/liquors than wine intake.