The Sol Goldman Pancreatic Cancer Research Center

Advances and Discoveries Made at Johns Hopkins


Predicting Risk in Families
Often people come to us with the question- "I have a strong family history of pancreatic cancer. What is my risk of getting the disease." Allison Klein and colleagues have developed a computer algorithm to answer this important question. The program can be used to estimate a person’s risk after their family tree (pedigree) has been entered. The program is available to trained genetic counselors.

Reference:
Wang W, Chen S, Brune KA, Hruban RH, Parmigiani G, Klein AP. PancPRO: risk assessment for individuals with a family history of pancreatic cancer. J Clin Oncol. 25:1417-22, 2007.


Inherited Breast Cancer Gene (BRCA2) Mutations
In addition to increasing the risk of breast and ovarian cancer, inherited (germline) mutations in the second breast cancer gene (BRCA2) increase the risk of pancreatic cancer. Dr. F. Couch and colleagues, in a collaborative multi-institutional study,examined a large number of individuals with a strong family history of pancreatic cancer, and found that inherited BRCA2 mutations account for 6% of moderate and high-risk pancreatic cancer families. Why is this important? This study is important because clinical testing for inherited BRCA2 gene mutations is now available. After appropriate genetic counseling, inviduals can be tested for a BRCA2 hene mutation and lives can be saved by breast and ovarian cancer screening.

Reference:
Couch FJ, Johnson MR, Rebe K, Brune K, deAndrade M, Goggins M, Gallinger S, Klein A, Petersen G, Hruban RH. The prevalence of BRCA2 mutations in familial pancreatic cancer. Cancer Epidemiol Biomarkers Prev. 16:342-6, 2007.


Precursor Lesions in the Pancreas
Dr. Kieran Brune and colleagues in the Sol Goldman Pancreatic Cancer Research Center carefully examined pancreases surgically resected from patients with a strong family history of the disease. The results were dramatic- many of these pancreases had multiple precancerous lesions and these precancerous lesions were microscopically associated with a very specific type of scaring called "lobulocentric atrophy." These findings are important because multifocal scarring (lobulocentric atrophy) is potentially clinically detectable using currently available imaging technologies (EUS). This suggests that screening for lobulocentric atrophy may one day become part of a screening test for early pancreatic cancer.

Reference:
Brune K, Abe T, Canto M, O’Malley L, Klein AP, Maitra A, Adsay NV, Fishman EK, Cameron JL, Yeo CJ, Kern SE, Goggins M, Hruban RH. Multifocal neoplastic precursor lesions associated with lobular atrophy of the pancreas in patients having a strong family history of pancreatic cancer. Am J Surg Pathol. 30:1067-76, 2006.