The Sol Goldman Pancreatic Cancer Research Center

What's New 2019


New test to guide the management of cysts in the pancreas

Cysts (collections of fluid caused by small tumors) of the pancreas present a real clinical challenge. While most are entirely harmless, some are precancerous and, if left untreated progress over time to pancreatic cancer. The problem is that it can be hard for doctors to know which cysts should be removed surgically and which are safe to follow without surgery. In the July 17th issue of the journal Science Translational Medicine, S. Springer and colleagues in the Sol Goldman Pancreatic Cancer Research Center report a new approach that could help guide the clinical management of patients with a cyst in their pancreas. The test, called "CompCyst" integrates a combination of clinical features, imaging findings, and cyst fluid genetics. Tested on over 400 patients, CompCyst proved to be much more accurate than just the clinician's judgement on whether or not a cyst needs to be removed surgically. The authors concluded that "application of the CompCyst test would have spared surgery in more than half of the patients who underwent unnecessary resection of their cysts. CompCyst therefore has the potential to reduce the patient morbidity and economic costs associated with current standard-of-care pancreatic cyst management practices." This test is not available yet as an approved clinical test, but pathologists in the Goldman Center are working to bring a clinical test to practice.

- August 2019



IPMN precursor lesions are more complex than thought

In the advance on-line June 5th issue of the journal Gastroenterology, Dr. Laura Wood and colleagues describe the results of the most detailed study to date of intraductal papillary mucinous neoplasms (IPMNs). IPMNs are a precancerous lesion of the pancreas. Like polyps of the colon, IPMNs of the pancreas are common and some, if left in place, can progress to invasive cancer over years. Understandings IPMNs is therefore a critical basis for preventing the development of invasive pancreatic cancer. In the study in Gastroenterology, Dr. Wood and colleagues used a panel of cutting edge molecular biology technologies, including whole-exome sequencing and in situ detection of mutations, to characterize IPMNs. They discovered that a single IPMN lesion can actually contain multiple genetically separate tumors (multiple independent clones). They also found that as IPMNs advance towards invasive cancer, a single clone dominates but there is still genetic complexity. This study, from the Sol Goldman Center, fundamentally changes our understanding of how IPMNs arise and progress to cancer. As the authors conclude, "Increasing our understanding of the mechanisms of IPMN" - could lead to strategies to identify patients at increased risk for pancreatic cancer.

- July 2019



Blood test to follow cancer treatment

In the May 29th advance on-line version of the journal Clinical Cancer Research, Drs. Vincent Groot and James Eshleman and their colleagues from the Sol Goldman Pancreatic Cancer Research Center describe a new blood test that can be used to follow effectiveness of treatment for patients with pancreatic cancer. The test for mutated KRAS genes shed by pancreatic cancer cells has been previously shown to work in the research setting. In this study, Dr. Eshleman and colleagues clinically validated the KRAS assay in a Clinical Laboratory Improvement Amendments (CLIA) and College of American Pathology (CAP) certified clinical laboratory. Using this test in the clinical setting, the investigators were able to show that measurement of KRAS in a CLIA laboratory setting can be used to predict recurrence and survival in patients with pancreatic cancer.

This is important because it suggests that the optimal therapy for patients with pancreatic cancer can be guided by their level of KRAS in their blood. Patients whose KRAS levels drop after therapy are likely responding to treatment and can be kept on the same treatment, while patients whose KRAS levels rise after therapy are likely not responding to treatment and their treatment can be changed.

- June 2019



The Importance of BRCA Genes in Guiding Therapy

Some (5-10%) pancreatic cancers are caused by inherited mutations in one of the breast cancer genes (called BRCA1, BRCA2 and PALB2). These inherited gene mutations are important for two reasons. First, they are important for other family members, as other family members may also inherit one of these mutations and they would benefit from knowing that they are at increased risk of developing cancer themselves. Second, pancreatic cancers that arise in patients with an inherited mutation in BRCA1, BRCA2 or PALB2 appear to be particularly sensitive to specific forms of chemotherapy. This second point is highlighted in the recently published POLO trial. The results of this phase III clinical trial were announced at the recent meetings of the American Society of Clinical Oncology. In this trial patients with a known BRCA gene mutation whose disease had not progressed on afirst-line platinum-based chemotherapy were treated with the drug called olaparib, a "PARP-inhibitor." They found that a clinically-meaningful and statistically significant improvement in progression-free survival for patients treated with olaparib compared to controls. The results of this trial are exciting, and highlight the importance of genetic testing for patients with pancreatic cancer. Indeed, the recent NCCN guidelines recommend genetic testing for all patients with pancreatic cancer. To learn more about the genes that cause pancreatic cancer, click here.

To learn more about this trial, see this article from AP News.

- June 2019



New Blood Test for Cancer

DELFI

A team of scientists at Johns Hopkins, led by Victor Velculescu, M.D.,Ph.D., report a new approach to a blood test for cancer. Reported in the journal Nature, the test can be used to detect seven different types of cancer, including pancreatic cancer. The test, called "DELFI" (DNA evaluation of fragments for early interception) detects abnormal fragments of DNA in the blood that have been shed by cancer cells. This technique takes advantage of the fact that cancers "package" their DNA differently than normal cells, and this unique packaging leads to unique patterns of DNA fragmentation that can be detected in the blood. DELFI detected close to 75% of cancer patients, and, remarkably, when combined with another blood test, DELFI could detect 91% of cancers.

Click here for the press release.

- May 2019



Using computer algorithms to identify pancreatic cancer

Researchers from the Sol Goldman Pancreatic Cancer Research Center at Johns Hopkins recently participated in a study that applied the new computer tool called "radiomics" to CT scans of the pancreas. The study, reported in the April issue of the American Journal of Roentgenology (AJR) showed that radiomics features can be used to identify pancreatic cancer in CT scans. The Hopkins team, which included radiologists, pathologists, computer scientists, and cancer biologists, analyzed computed tomography (CT) scans from 380 patients - 190 with pancreatic cancer and 190 healthy controls. Their initial analysis revealed 40 radiomics features which were then used to classify a set of validation scans as either cancer or normal. This new classifier had >99% accuracy and correctly identified all cases of pancreatic cancer, suggesting it could be a powerful complement to human review of imaging data. The study suggests that computer programs can be developed that will help radiologists diagnose pancreatic cancer more accurately. To learn more, visit: https://www.ajronline.org/doi/full/10.2214/AJR.18.20901

- May 2019



4th Sol Goldman International Conference

The 4th Sol Goldman International Conference on Pancreatic Cancer was held April 10-11, 2019 on the Mount Washington campus of the Johns Hopkins University School of Medicine. The focus of this year's Think Tank was familial pancreatic cancer. The discussions were broad and deep, and most of all wonderfully thought provoking. The think tank ended with a lively discussion of impactful ways to move the field forward. Participants included:

Emmanuel Antonarakis, MD (Johns Hopkins University School of Medicine),
Susan Domchek, MD (University of Pennsylvania),
Elliot Fishman, MD (Johns Hopkins University),
Michael Goggins, MD (Johns Hopkins University),
Ralph Hruban, MD (Johns Hopkins University),
Reed Jobs (Emerson Collective),
David Kelsen, MD, PhD (Memorial Sloan Kettering Cancer Center),
Scott Kern, MD (Johns Hopkins University),
Kenneth W. Kinzler, PhD (Johns Hopkins University),
Alison Klein, PhD, MPH (Johns Hopkins University),
Benjamin Lewis, MD (New York-Presbyterian/Columbia),
Prof. Christopher Lord, DPhil (The Institute of Cancer Research, London, United Kingdom),
Nicholas Papadopoulos, PhD (Johns Hopkins University),
Nicholas Roberts, VetMB, PhD (Johns Hopkins University),
Patrick Soon-Shiong, MD (NantWorks),
Ian Tomlinson, PhD, FRCPath, FMedSci (University of Birmingham),
Bert Vogelstein, MD (Johns Hopkins University),
Joshua Vogelstein, PhD (Whiting School of Engineering, Johns Hopkins University),
R. Jacob Vogelstein, PhD (Camden Partners Holdings, LLC),
George Zogopoulos, MD, PhD (McGill University),
Lee Zou, PhD (Harvard Medical School).

Think Tank 2019

Think Tank 2019
(click group picture to enlarge)

- April 2019



Emma's Crafts for a Cure

Emma Shaw is seven years old and lost her grandfather to pancreatic cancer in 2017. To honor his memory she started "Emma's Crafts for a Cure". Emma makes and sells jewelry at local events, specifically to raise money for the Sol Goldman Pancreatic Cancer Research Center. Over her Christmas break Emma and her parents came to Johns Hopkins, toured the pancreatic cancer research labs and presented a check for over $500 to support research in the Goldman Center. What a remarkable young woman!

Emma's Crafts for a Cure

Emma's Crafts for a Cure

Emma's Crafts for a Cure

- January 2019



Remembering John (W)

On August 18, 2018, a group of John's friends gathered together to remember John and to ride to raise donations in support of Pancreatic Cancer Research at the Johns Hopkins Sol Goldman Pancreatic Cancer Research Center. This was the 7th annual REMEMBERING JOHN (W) ride and the group covered 20+ miles on the York Heritage Railtrail from Hanover Junction to the Mason-Dixon line and back. They raised $3,300 for cancer research.
View more event pics and read more about John (W) »

Remembering John W 2018

- January 2019