Welcome to Study of the Week from Patient Worthy. In this segment, we select a study we posted about from the previous week that we think is of particular interest or importance and go more in-depth. In this story we will talk about the details of the study and explain why it’s important, who will be impacted, and more.

If you read our short form research stories and find yourself wanting to learn more, you’ve come to the right place.

This week’s study is…

Digital spatial profiling of intraductal papillary mucinous neoplasms: Toward a molecular framework for risk stratification

We previously published about this research in a story titled “Scientists Identify Biomarkers to Predict Pancreatic Cancer Development” which can be found here. The study was originally published in the research journal Science Advances. You can read the full text of the study here. 

This research team was affiliated with the Duke University School of Medicine.

What Happened?

A cancer diagnosis is never welcome news, but some types of cancer can be more devastating than others. One of the worst is pancreatic cancer, which can spread aggressively, responds poorly treatment, and is often diagnosed at an advanced stage. With current therapy regimens for this cancer being relatively ineffective, one of the best methods of combatting pancreatic cancer is preventing it from appearing in the first place. In this study, the research team sought to detect biomarkers that could predict whether lesions located on the pancreas were likely to develop into a cancer tumor.

This study was focused primarily on pancreatic ductal adenocarcinoma, the most common kind of pancreatic cancer. The lesions that the team were working with in this study are called intraductal papillary mucinous neoplasms (IPMNs). While IPMNs typically do not develop into cancer, they are absolutely capable of doing so, and determining which lesions are at risk would allow for their removal. The scientists harnessed an approach called digital spatial RNA profiling on the lesions. This approach allowed them to evaluate the lesions for regions of high-grade and low-grade abnormal cell proliferation.

The Duke team was able to identify genetic mutations that appeared to either suppress or stimulate abnormal cell growth. They also identified biomarkers for distinguishing the two previously known variants of IPMNs and also found a third variant that hadn’t been described before. They determined that this new variant usually resulted in less aggressive disease. The biomarkers allowed the scientists to distinguish between faster and slower growing subtypes. The researchers concluded that these findings could help lead to the develop of a predictive biopsy for pancreatic cancer that could have greater accuracy than current diagnostic approaches. If precancerous lesions can be identified and removed, then the rates of death from pancreatic cancer, along with the number of cases overall, could be curtailed.

About Pancreatic Cancer

Pancreatic cancer is one of the most dangerous forms of cancer. The disease affects the pancreas, which is a glandular organ that is situated behind the stomach. Part of the reason that pancreatic cancer is so dangerous is that it rarely produces noticeable symptoms until it has reached an advanced stage and begun to spread. However, even when detected earlier, it is difficult to treat effectively. Risk factors for pancreatic cancer include being male, old age, African-American ancestry, family history, smoking, obesity, diabetes, chronic pancreatitis, and a diet heavy in red meat, processed meat, or meat cooked at very high temperatures. Symptoms include depression, upper abdominal pain, jaundice, diabetes, constipation, weight loss, and appetite loss. Treatment approaches for this cancer include surgery, chemotherapy, and radiation therapy. Even with heavy treatment, pancreatic cancer almost always returns. The five-year survival rate is just ten percent. To learn more about pancreatic cancer, click here.

Why Does it Matter?

Outcomes in pancreatic cancer are especially poor, and the medical community is searching for any potential advantage in order to help turn the tide against this devastating disease:

“Even when pancreas cancer is detected at its earliest stage, it almost always has shed cells throughout the body, and the cancer returns.” – Peter Allen, MD, Senior Author, Chief, Division of Surgical Oncology, Department of Surgery, Duke University School of Medicine

Because of how poorly this cancer responds to treatment, preventing its development might the best approach to reduce impacts:

“That’s why we shifted our focus to these precancerous cysts, known as intraductal papillary mucinous neoplasms, or IPMNs…we are creating an opportunity to prevent an incurable disease from developing.” – Allen

The researchers say that their next step on this research path is to work on detection of the biomarkers in cyst fluid. If they can succeed in this task, then the ability to develop a protein biopsy that could determine whether a cyst needs to be removed would be in reach.