Randy Brand Updates

As everyone knows, pancreatic adenocarcinoma (PDAC) --- that is, pancreatic cancer --- has an overall 5-year survival of 13%. PDAC is the 3rd most common cause of cancer deaths in the United States, despite accounting for only 2% of all malignancies. Only a minority of patients (less than 15%) are diagnosed with “localized” disease, which has a 5-year survival rate of about 44% in setting of a node-negative, margin-negative pancreatic resection. An obvious strategy for improving this unacceptable survival rate would be to detect PDAC early on, when it’s localized and is at a more curable stage. Pancreatic cancer is too rare to screen the general population, but screening is warranted in individuals at an increased risk for developing this cancer. A blood test that can be incorporated into a screening strategy would be of great value for these high-risk individuals.

CA 19-9 is a protein that is FDA approved to monitor treatment responses in pancreatic cancer patients. Although CA 19-9 is consistently one of the best tested biomarkers for early detection of pancreatic cancer, its performance characteristics limit widespread use. In part, this is because a subset of the population cannot make this protein and another subset of individuals have a higher-than-normal level, which is normal for them but confuses doctors since they think this person may have cancer (a false positive result). We now understand how this protein is made and can better predict patient responses by looking at a person’s DNA (genotyping). However, more work needs to be done to make CA 19-9 a reliable identifier for pancreatic cancer.

Access to funds from the Wayne Fusaro Pancreatic Cancer Research Fund support the cost of obtaining CA 19-9 levels and genotyping in high-risk individuals with a genetic predisposition for developing pancreatic cancer. These efforts are part of the CAPS 5 Consortium, which is a multicenter study led by Johns Hopkins University and includes UPMC, University of Pennsylvania, Dana Farber Cancer Institute, University of Michigan, University Hospitals in Cleveland, Yale, and Columbia. The goal of this study is to learn if CA 19-9 has value for pancreatic cancer surveillance as a stand-alone biomarker or as part of biomarker panel when genotyping data is incorporated into the interpretation of the results.

I am grateful to the Fusaro family, the WFPCRF board, and all of you --- the many volunteers and donors committed to eradicating pancreatic cancer.