|
|
|
|
|
|
|
|
|
|
|||||||
 |
 |
 |
||||||||
|
Catching Pancreatic Cancer EarlyBy Sunita Patterson
While researchers refine treatment strategies, they’re also working on screening strategies. “The long-term approach in dealing with pancreatic cancer is going to be in prevention and earlier detection,” said James L. Abbruzzese, M.D., a professor in and chair of the Department of Gastrointestinal Medical Oncology at The University of Texas M. D. Anderson Cancer Center. “If we could detect the disease very early, some of our currently available therapies would be much, much more effective.” Currently, the trigger for performing diagnostic studies is the development of symptoms, such as jaundice, abdominal or back pain, digestive issues, a change in urine or stool color, or the sudden onset of diabetes. But because symptoms usually develop after the disease has progressed, early detection is rare. Improving early detection rates would mean screening asymptomatic patients. What type of screening strategy would be practical? Because of the rarity of pancreatic cancer, mass screening of the public would not be reasonable. However, screening of those at increased risk for the disease would be worthwhile. One such group is people who have a mutation of the BRCA2 gene or who have multiple family members who’ve developed pancreatic cancer. This group is eligible now for an M. D. Anderson clinical trial that examines whether a combination of imaging modalities (endoscopic ultrasonography, computed tomography, and magnetic resonance imaging or magnetic resonance cholangiopancreatography) can detect early-stage disease. In the lab, M. D. Anderson researchers are looking for biomarkers of early-stage pancreatic cancer or, better yet, of its precursor, pancreatic intraepithelial neoplasia (PanIN). What would be ideal, said Craig Logsdon, Ph.D., professor in the Department of Cancer Biology, is a biomarker that identifies PanIN 3, the last stage of PanIN before malignant transformation occurs. Further, the ideal biomarker would distinguish PanIN 3 from chronic pancreatitis, a more common, benign disease (the best biomarker thus far, CA19-9, is elevated in both pancreatic cancer and chronic pancreatitis). Two recent advances are going to help Dr. Logsdon and colleagues in their search. First, they’ve created a mouse model in which PanIN develops and transforms into pancreatic cancer. This model provides the opportunity to look at early-stage disease, which is hard to do in humans because pancreatic cancer is usually found so late. The second advance is a new assay, developed in conjunction with Gordon B. Mills, M.D., Ph.D., chair of the Department of Systems Biology at M. D. Anderson, that will make the testing of candidate biomarkers much more feasible. The standard testing method, enzyme-linked immunosorbent assay, requires a fairly high volume of blood (50–100 mL) and the use of two antibodies, which is expensive. The new reverse-phase protein array (RPPA) requires only 1 mL of blood and one antibody. The RPPA will now enable Dr. Logsdon to test a panel of 20 candidate biomarkers that he identified in earlier studies. These advances—the model of early-stage disease and the new assay for testing candidate pancreatic cancer biomarkers—are overcoming the two big obstacles that have kept researchers from making headway with identifying biomarkers, Dr. Logsdon said. “These breakthroughs are going to accelerate discovery.”For more information, call Dr. Abbruzzese at 713-792-2828. Other articles in OncoLog, October 2008 issue:
Home/Current Issue | Previous Issues | Articles by Topic | Patient Education ©2009 The University of Texas M. D. Anderson Cancer Center |
|||||||
TOP