Pancreatic Cancer Screening in Our Future?

Sylvester researchers are collaborating with scientists around the world to develop early detection methods for pancreatic cancer.

Nipun Merchant, M.D.
Sylvester researcher Nipun Merchant, M.D., is working to diagnose pancreatic cancers earlier.

While there is no standard method for early detection of pancreatic cancer, a combination of imaging and blood-based tests may detect the disease in people at increased risk due to family history, genetic mutation, diabetes, smoking, age or other factors.

According to the National Cancer Institute, the five-year survival rate for pancreatic cancer is 44.3% when the disease is localized. This drops to 15% when the tumors are regional and 4% when they are distant.

Pancreatic cancer is advanced in 80% to 85% of patients at diagnosis, said Sylvester Comprehensive Cancer Center researcher Nipun Merchant, M.D., director of the Sylvester Pancreas Cancer Research Institute and professor and chief of the Division of Surgical Oncology at the University of Miami Miller School of Medicine. Only around 10% to 15% can undergo a surgical resection.

“The goal is to try to diagnose these cancers at a much earlier stage,” said Dr. Merchant.

In Search of Pancreatic Cancer Biomarkers

Disease biomarkers—objective measures of what is happening in a cell or an organism in real time—enable researchers to profile tumors and make a diagnosis or monitor treatment effects. Physicians rely on biomarkers to detect prostate and colon cancers early enough for effective treatment.

“We don’t have a PSA or a colonoscopy,” said Dr. Merchant.  “We don’t have anything like that in pancreas cancer.”

 A current Sylvester study is providing genetic testing and MRI every six months to a year to patients at high risk for pancreatic cancer due to late-onset diabetes and BRCA 1 and 2 mutations.

“We are tracking it over time so we can see when pancreas cancer develops in these high-risk individuals to be able to identify it at an early stage,” said Dr. Merchant. “We have blood samples from these patients so we can start looking at their blood for potential biomarkers.”

Collaborative Efforts to Fight Pancreatic Cancer

The Pancreatic Cancer Action Network (PanCAN) advisory board collaborates with industry partners to award and distribute $10 million in research grants annually. Pharmaceutical company engagement is a challenge, said Peter Hosein, M.D., co-leader, Gastrointestinal Cancers Site Disease Group, associate director of clinical research for Sylvester Pancreatic Cancer Institute and associate professor of clinical medicine at the Miller School.

Peter Hosein, M.D., standing in his lab
Peter Hosein, M.D., is a member of the PanCAN advisory board that is engaging industry to accelerate drug development.

“Drug development for pancreatic cancer has been very difficult up until now,” said Dr. Hosein who, this summer, was appointed to PanCAN’s Scientific and Medical Advisory Board. “Through its Clinical Trials Consortium bringing together the leading pancreas centers in the country, PanCAN has developed an innovative platform that makes it very attractive for pharmaceutical partners to engage in the efforts to accelerate drug development efforts.”

“PanCAN is probably doing more for the advancement of pancreas cancer outcomes than almost any group in the world,” said Dr. Merchant. “They lobby Congress for increases in pancreas cancer research funding. The increases in research funding are linked to increases in survival rates for pancreatic cancer over the last decade.”

“Some of the clinical trials we have are likely to bring promising treatments closer to approval,” said Dr. Hosein. “We now have more funding that is probably going to pay off in the next few years.”

In addition to PanCAN, the Pancreatic Cancer Early Detection Consortium (PRECEDE) is an international collaboration of experts dedicated to improving the survival rate for pancreatic cancer patients through detection, screening, prevention and risk modeling. PRECEDE aspires to increase the five-year survival rate to 50% over the next decade and runs an international study that tracks the progress of 15,000 patients at risk for pancreatic cancer.

The ultimate goal of these consortia is to bring researchers, diagnosticians, practitioners and patients together to identify barriers to treatment and improve outcomes for this challenging disease, with Sylvester scientists playing pivotal roles.

Tags: Dr. Nipun Merchant, Dr. Peter Hosein, pancreatic cancer, Sylvester Comprehensive Cancer Center