Florida Pancreas Collaborative
Among the top causes of cancer death in the United States and Florida, pancreatic cancer is the deadliest, with a 5-year relative survival rate of 7%. This dismal prognosis is primarily attributed to the lack of early detection strategies. Based on changing demographics and incidence and death rates, pancreatic cancer is projected to surpass breast, prostate, and colorectal cancer and become the second leading cause of cancer deaths by 2020. Coinciding with the rise in pancreatic cancer incidence and mortality has been an increase in the radiologic detection of cystic lesions of the pancreas including intraductal papillary mucinous neoplasms (IPMNs). IPMNs are the most common pancreatic cancer precursors and account for 40% of the 150,000 asymptomatic pancreatic cysts detected incidentally through computed tomography (CT) or magnetic resonance imaging (MRI) each year. The only way to treat these cysts and examine severity is through surgical resection and pathological evaluation. However, pancreatic resection is associated with significant risks of morbidity (including long-term diabetes) and even mortality.
Drs. Jenny Permuth and Mokenge Malafa and other Moffitt colleagues including Dr. Dung-Tsa Chen, have highlighted microRNAs (miRNAs) circulating in the blood as biomarkers that can help distinguish pre-operatively between ‘low-risk/benign’ IPMNs that can be monitored from ‘high-risk/malignant’ IPMNs that should undergo surgical resection. To build on this research, Drs. Permuth and Malafa partnered with collaborators Dr. Nipun Merchant (The University of Miami) and Dr. Jose Trevino (The University of Florida), and recently obtained funds from the Florida Academic Cancer Center Alliance to establish The Florida Pancreas Collaborative: A Partnership Dedicated to the Early Detection and Prevention of Pancreatic Cancer. This prospective, multi-center study will develop state-wide infrastructure to evaluate putative risk factors for and biomarkers of early pancreatic cancer development and progression by longitudinally collecting biospecimens and clinical, epidemiologic, and radiologic data from patients newly diagnosed with IPMNs, other diseases of the pancreas (such as other types of pancreatic cysts, pancreatitis, or PC), and healthy controls. As part of this study, the team will evaluate the diagnostic performance of the circulating miRNA signature they have developed using this larger dataset. An overarching goal of this line of research is to integrate novel molecular and radiologic data with standard clinical characteristics and develop a clinical decision model that can rapidly and cost-effectively personalize care for patients with IPMNs and ultimately reduce the burden of pancreatic malignancy.