Thanks to private funding, 100% of every dollar donated to The Lustgarten Foundation goes directly to pancreatic cancer research.

Earlier Detection Initiatives

WORKING TO DIAGNOSE PANCREATIC CANCER EARLIER

Too often, pancreatic cancer patients are not diagnosed until after their disease has spread and surgery is not a viable option. At the Lustgarten Foundation, we are committed to working with world-renowned pancreatic cancer experts who are pursuing novel approaches to detect the disease earlier, which will empower patients.

Lustgarten Foundation Distinguished Scholar Dr. Bert Vogelstein at the Jons Hopkins Kimmel Cancer Center is leading several earlier detection projects with the goal of developing screening methods like we have for breast and colon cancer. One of Dr. Vogelstein’s multiyear earlier detection projects involves bringing together scientists from a broad range of disciplines such as radiology, physics, and vision science, which encompasses areas including how visual information is processed and how artificial systems can also process this information. This project is focused on using computers to recognize patterns in medical images just like driverless cars can identify roads, traffic and people. In this case, the hope is to apply advanced technology to CT and MRI images to detect the subtle early changes of pancreatic malignancy that a diagnostician may miss.





DrVogelstein


“Years from now, death from cancers will be a lot less common, and that’s going to be in large part due to earlier detection.” – Dr. Bert Vogelstein

Researchers will create an “image bank” with scans from many patients, some with a normal pancreas and others with an abnormal pancreas. By comparing images we will be able to optimize MRI scanning, allowing for improved image resolution and a more rapid process. As a result of this project, researchers hope that patients’ pancreatic cancer tumors will be detected earlier.

“We hope to teach computers to not only locate a pancreas in patient images, but to tell the earliest differences between a normal pancreas and one that is diseased,” said Dr. Vogelstein.

Another avenue of research that Dr. Vogelstein is investigating is the “liquid biopsy.” From a simple vial of blood, researchers are finding the telltale genetic material that comes from the pancreatic cancer well before symptoms appear. Dr. Vogelstein and colleagues are now analyzing data from pancreatic cancer patients at various stages of the disease. Early results show that about 40 to 60 percent of localized pancreatic cancers are detectable with liquid biopsies. The goal is to make the technology more accurate.

Dr. Vogelstein is optimistic about the technology’s potential, buoyed in part by significant interest from the pharmaceutical industry. “There was a time when people looked at early detection and prevention with a lot of skepticism, but once industry gets involved and sees the value, there is a significant chance that it gets into the clinic setting much sooner,” he said.

Due to advances in imaging technologies, more people are being diagnosed with pancreatic cysts. In fact, up to 13 percent of people will have pancreatic cysts show up in a CT scan or an MRI. Some cysts may never cause any problems and require monitoring only. Others have the potential to become malignant and require surgery. Currently, doctors must test fluid from the cyst for certain markers that may signify cancer, but the test is only accurate about half of the time, often leading to unnecessary surgeries and potential complications.

In response, our researchers have identified a panel of genetic markers, which when combined with clinical expertise, can more accurately differentiate between the various types of pancreatic cysts. The aim is to identify cysts that are safe to monitor over time versus those that have the potential to become malignant. Early trials are promising and work is underway to recruit more patients for larger trials.

DETECTING CANCER THROUGH A SINGLE BLOOD TEST

Researchers led by Dr. Vogelstein at the Johns Hopkins Kimmel Cancer Center have designed a blood test called CancerSEEK that can detect the presence of pancreatic cancer as well as ovary, liver, stomach, esophagus, colorectal, lung and breast cancers. The test has the capacity not only to identify the presence of relatively early cancer, but also to localize the organ of origin of these cancers.

“The potential this has for pancreatic cancer is unprecedented,” said Anne Marie Lennon, M.D., Ph.D., Associate Professor of Medicine, and Director, Pancreatic Cyst Center of the Ludwig Center at the Johns Hopkins Kimmel Cancer Center. “We know that in 80%-85% of pancreatic cancer cases, it’s detected too late, leaving the patient with few options. Developing a blood screening test for pancreatic cancer has been an urgent goal, because catching the disease early will be the way we get to long-term survival.”

The test results for pancreatic cancer were very promising. The sensitivity of the detection method was 72% and the specificity was greater than 99%. Sensitivity and specificity are terms used to evaluate a clinical test. Sensitivity is the ability of a test to correctly identify those with the disease (true positive), whereas test specificity is the ability of the test to correctly identify those without the disease (true negative). New blood tests for cancer must have very high specificity; otherwise, too many healthy individuals will receive positive test results, leading to unnecessary follow-up procedures and anxiety.

This test is so critical because these eight cancers account for more than 60% of cancer deaths, and pancreatic cancer and four others in the panel have no screening test available. This study lays the foundation for a single blood screening test for multiple cancers that could be offered as part of routine medical checks. The estimated cost for the test will eventually be less than $500, which is comparable to or lower than other screening tests for single cancers, such as a colonoscopy. While further studies are necessary to establish the clinical utility of CancerSEEK and demonstrate that it can save lives, this test marks a significant first step toward a new era in how pancreatic cancer is diagnosed. The next steps are to increase the sensitivity of CancerSEEK and to test it on high risk patients, which the Foundation is funding.


Pancreatic Cyst and Cancer Early Detection Center

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