The Sol Goldman Pancreatic Cancer Research Center

What's New


Patients who have an IPMN surgically resected need to be followed clinically

- November 2020

The team from Hopkins recently reported their experience with close to 450 patients who had an intraductal papillary mucinous neoplasm (IPMN) of the pancreas resected. In the study, reported in the Annals of Surgery (PMID 33201121), the authors clinically followed 449 consecutive patients who had a non-invasive IPMN surgically resected at Johns Hopkins between 1995 and 2018. Remarkably, 16 (3.6%) of the patients developed an invasive cancer in their remnant pancreas during the period of follow-up. The authors estimated the risk of progression was 6.4% at five years after surgery, and 12.9% at 10 years after surgery. These results add to the growing body of evidence that suggest that patients should be clinically followed after they have had surgery for an IPMN because they have a small, but real, risk of developing cancer in their remnant pancreas.



2020 Goldman Think Tank

- October 2020

The Sol Goldman Center held its International Think Tank by Zoom this year! The focus was on the important topic of pancreatic cysts and precancers. This included "intraductal papillary mucinous neoplasms," and other precancerous lesions of the pancreas. Over 40 scientists participated, including prominent scientists from Japan, The Netherlands, Italy, Israel, and from all across the US.

Dr. Laura Wood gave the keynote, and even though the conference was held by Zoom, the day was filled with lively thought provoking discussions.

(click the images to enlarge)
Think Tank 2020

Think Tank 2020

Think Tank 2020

Think Tank 2020



2020 AACR Team Science Prize

- June 2020

The 2020 Team Science Prize from the American Association for Cancer Research was awarded to The Cancer Genome Atlas (TCGA). The TCGA led an effort to sequence the DNA of all major cancer types. Ralph Hruban, M.D. from Johns Hopkins was included as one of the recipients of the AACR's Team Science Prize as he co-led together with Benjamin Raphael, the TCGA's effort to sequence pancreatic cancer. This is an amazing third time that the pancreatic cancer team at Hopkins has been recognized with the Team Science Award. The Hopkins team won it in 2013 for the first sequencing of all of the genes in pancreatic cancer, in 2017 for new approaches to the early detection of cancer (the "liquid biopsy"), and now again in 2020. These awards highlight the collaborative spirit that characterizes the pancreatic cancer research team at Johns Hopkins.
Congratulations to Dr. Hruban and to the team!



Naomi Miller: Supporting Johns Hopkins Pancreatic Cancer Research

- April 2020

Naomi Miller Singer and comedic actress, Naomi Miller, will be performing a virtual concert on Facebook Live, entitled "Love, Marriage, Children and Liposuction" on Sunday, April 5, 2020 at 10:00 am in memory of her beloved husband, Harvey, who succumbed to pancreatic cancer on January 10, 2020. Naomi is raising support for early detection pancreatic cancer research at Johns Hopkins. Please attend the concert virtually by clicking this facebook link.

To learn more about Naomi Miller and her career, visit - www.naomimiller.com



Enormous study of the DNA changes across 38 tumor types

- February 2020

The journal Nature just published (nature.com/collections/afdejfafdb) and (nature.com/articles/s41586-020-1969-6), a series of remarkable papers that integrate a number of large studies of the genetic (DNA) changes in a large number of cancer types. A number of faculty in the Sol Goldman Pancreatic Cancer Research Center participated in these studies. For example, the paper "Pan-cancer analysis of whole genomes," integrated 2,658 whole-cancer genomes (studies of all of the DNA changes) across 38 cancer types, including pancreatic cancer. The investigators used data from the International Cancer Genome Consortium (ICGC) and The Cancer Genome Atlas (TCGA), and found that the average cancer has 4 to 5 "driver" mutations (mutations that clearly promote cancer growth), and that "catastrophic" genetic events, called chromothripsis, are more common and occur earlier than previously thought. The driver mutations for pancreatic cancer are usually in the KRAS, TP53, SMAD4 and p16/CDKN2A genes. Large scale studies such as these that integrate multiple datasets can be powerful as they can detect subtle patterns that can be missed in smaller studies.



New living cell line of precancer of the pancreas created

- February 2020

Investigators from the Sol Goldman Pancreatic Cancer Research Center at Johns Hopkins recently published the first report of a cell line derived from an intraductal tubulopapillary neoplasm (ITPN) of the pancreas. This study, co-lead by principal investigators Dr. Laura Wood and Dr. Nicholas Roberts, reports the molecular and functional characterization of this new cell line. To create the cell line, the authors used a combination of three-dimensional organoid culture and traditional two-dimensional cell culture. Intriguingly, they demonstrate that the cancer-associated properties of the cell line, such as colony formation and invasion, are intermediate between normal ductal cells and bona fide invasive pancreatic cancer cells, consistent with its identity as a precancerous lesion. This novel cell line represents an important model for further investigation of ITPNs and precancerous pancreatic lesions more generally. Moreover, it highlights three-dimensional culture as a tech nique to propagate early neoplasms in culture, with the potential to transition to traditional two-dimensional approaches for further studies.



More early stage pancreatic cancers are being detected!

- January 2020

A team led by Dr. Michael Goggins in the Sol Goldman Center just published an extensive review of pancreatic cancers reported in the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) database (Blackford et al, J Natl Cancer Inst. 2020 Jan 20;). They found that the incidence (number) of early stage (stage IA) pancreatic cancers is increasing. Coupled with this increase, they found that the average age of patients with stage I disease is decreasing. They also report that patients with Stage IA disease are more likely to carry insurance (versus Medicaid/none) than are higher-stage cases.

These findings are exciting as it suggests hope for the early detection of pancreatic cancer. Or, as the authors write: "these trends may be the result of improved early diagnosis and early detection."



2020 Cancer Statistics Released

- January 2020

The American Cancer Society just published, in the journal CA: A Cancer Journal for Clinicians, the latest cancer statistics in the United States. The authors report that "In 2020, 1,806,590 new cancer cases and 606,520 cancer deaths are projected to occur in the United States. The cancer death rate rose until 1991, then fell continuously through 2017, resulting in an overall decline of 29% that translates into an estimated 2.9 million fewer cancer deaths than would have occurred if peak rates had persisted."

The authors estimate that in 2020 approximately 57,600 Americans will be diagnosed with pancreatic cancer, and 47,050 will die from pancreatic cancer. In a hopeful sign, the five-year relative survival rate for patients with pancreatic cancer is 9%, better, but still way too low!

The report highlights the importance of smoking cessation, weight control and early detection in reducing cancer deaths. For patients with pancreatic cancer, the study highlights the importance of early detection. Patients with localized disease had a 37% five-year survival, patients with regional disease a five-year survival rate of 12% and patients with distant disease a five-year survival rate of only 3%.

We should all be encouraged by the many lives saved with the remarkable decline in overall cancer rates. The study does, however, painfully highlight the work that needs to be done fighting pancreatic cancer. New approaches to early detection, and new therapies are sorely needed.



Two recently published papers highlight the risk of recurrence after the surgical resection of an intraductal papillary mucinous neoplasm of the pancreas

- January 2020

Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are non-invasive precancerous lesions, some of which, over time progress to invasive pancreatic cancer. If an intraductal papillary mucinous neoplasms of the pancreas is removed, it will not progress to invasive cancer. Intraductal papillary mucinous neoplasms of the pancreas therefore represent an opportunity to cure a pancreas tumor, before it becomes cancer.

While removing an intraductal papillary mucinous neoplasm of the pancreas prevents the lesion that was removed from progressing to pancreas, the remnant (remaining) pancreas remains at risk. Just as patients who have had a colon polyp removed need to be more carefully monitored for more colon tumors, so do the patients who have had an intraductal papillary mucinous neoplasms of the pancreas surgically resected need to be monitored for additional pancreas tumors.

Two papers that were just published help answer important questions in the post-operative monitoring of these patients.
https://www.ncbi.nlm.nih.gov/pubmed/30413822
https://www.ncbi.nlm.nih.gov/pubmed/31463655

First, what is the magnitude of the risk of recurrence after the surgical resection of an intraductal papillary mucinous neoplasm of the pancreas? The reported risk varies, but these two papers, combined with several previously published papers, suggest that the risk of getting a new significant lesion in the remnant pancreas in the five years after surgery is in the range of 5-15%. Patients who had an intraductal papillary mucinous neoplasm of the pancreas with "high-grade dysplasia" resected have a higher risk than do patients who had an intraductal papillary mucinous neoplasm of the pancreas with "low-grade dysplasia" resected.

Second, does the risk ever go down to zero, or do we have to monitor patients indefinitely? Both studies suggest that the risk persists. One cannot identify a certain number of years after surgery where it is safe to stop monitoring. In fact, both studies show that the risk persists well beyond five years after surgery. Why is this important? These studies reinforce a growing body of literature that emphasize the importance of monitoring patients who have had an intraductal papillary mucinous neoplasm of the pancreas resected. They also show that this monitoring should, when clinically indicated, be indefinite.

For more information, visit: http://pathology.jhu.edu/pancreas/cyst/index.php