Active Research Projects

Pancreatic cancer remains the fourth leading cause of cancer deaths in the United Status. In spite of tremendous research efforts, there has been little advance in outcomes over the last decades.

The UMass Memorial Pancreatic Program is the only comprehensive program for the care of patients with pancreatic disease in Central Massachusetts. Our mission is to optimize patient care and outcomes for patients affected with these diseases.

The multidisciplinary Pancreatic Program seeks to advance the management and treatment of these patients by integrating groundbreaking basic science and patient-oriented research with improved access to clinical trials and cutting edge therapies.

UMass Pancreatic Ongoing Research Activities

1. Clinical Research

The group has many ongoing clinical reviews that are ongoing. A summary of projects includes:

  • Short and long term endocrine and exocrine insufficiency after pancreatic resection
  • Outcomes after resected duodenal adenocarcinoma
  • Evaluation of neoadjuvant chemotherapy for pancreatic cancer on outcome and quality
  • Serologic predictors of response and outcome for patients with pancreatic cancer
  • Prognostic features after resection of pancreatic neuroendocrine tumors

2. Basic Science and Translational Research

a. microRNA Predictors of Response and Outcome (PIs: Victor Ambros, PhD, Jennifer LaFemina, MD)
In collaboration with Victor Ambros, PhD (a world-renowned scientist who is responsible for discovering microRNA), the Pancreas Program is evaluating microRNA markers of response and outcome in patients with pancreatic cancer. Preliminary data is available and is currently undergoing confirmatory studies. When confirmed, data will be validated by collaborating institutions and with population-based analysis.

b. DNA Predictors of Response and Outcome (PIs: Lloyd Hutchinson, PhD, Jennifer LaFemina, MD)
In collaboration with Lloyd Hutchinson, PhD, the Pancreas Program is utilizing novel DNA deep sequencing technology to evaluate DNA predictors of response and outcome of patients with pancreatic cancer. Data will help predict patient outcome and response, but will also be extrapolated to identify novel therapeutic targets by which patients may be treated in a personalized fashion.

3. Other Related Projects Being Conducted

  • Development of Quality of Life Instrument for Chronic Pancreatitis: PANQOLI
  • Evaluation of smoking on quality of life in chronic pancreatitis patients
  • Pancreatic cyst evaluation-role of DNA analysis
  • Endoscopic necrosectomy in necrotizing pancreatitis: outcome evaluation
  • EUS-guided ERCP rendez-vous: outcome evaluation
  • In-patient Chronic pancreatitis management-impact of management plan

4. High-Risk Pancreas Clinic

Approximately 10% of pancreatic cancer cases are hereditary in nature. Syndromes, such as von Hippel Lindau (vHL), Peutz-Jegher syndrome (PJS), Familial Atypical Multiple Mole Melanoma syndrome (FAMMM), Familial Pancreatic Cancer, and Hereditary Pancreatitis, place patients and family members at a significantly increased risk of developing pancreatic cancer. Other syndromes, including neurofibromatosis 1 (NF1), multiple endocrine neoplasia 1 (MEN1), BRCA 1 and 2, Lynch syndrome, Familial Adenomatosis Polyposis (FAP), Tuberous Sclerosis (TS), and a history of affected family members, increase personal and family risk by a moderate amount.

Unfortunately, at this time there are no national guidelines regarding surveillance of these patients. However, theoretically, early detection of precancerous and cancerous lesions may lead to an improved rate of cure.

The UMass Pancreas Program has announced the High-Risk Pancreas Clinic, which formally opened on May 24, 2013. This is a multidisciplinary clinic in which patients who have an intermediate or high risk of developing pancreatic cancer will be evaluated by the surgical oncology, gastroenterology, and genetic teams. Management strategies, including surveillance and genetic screening, will be discussed.

Research projects including evaluation of the efficacy of screening intermediate populations and assessment of emerging screening techniques will be studied within the context of the clinic.

5. Recent Pancreatic Team Publications and Presentations

Publications

Correa C, Do R, Gonen M, LaFemina J, D’Angelica M, DeMatteo RP, Fong Y, Kingham TP, Brennan MF, Jarnagin WR, Allen PJ. Invasive carcinoma in intraductal papillary mucinous neoplasms of the pancreas can be predicted with a nomogram. Ann Surg Oncol. Epub ahead of print.

Furman M, Lambert L, Sullivan M, Whalen G. Rational follow-up after curative cancer resection.
J Clin Oncol. 2013;31(9):1130-3.

Frankel TL, LaFemina J, Bamboat Z, D’Angelica M, DeMatteo RP, Fong Y, Kingham TP, Jarnagin WR, Allen PJ. Dysplasia at the surgical margin predicts recurrence following the resection of non-invasive intraductal papillary mucinous neoplasm. HPB. 2013;15(10):814-21

LaFemina J, Chou JF, Gonen M, Correa-Gallego C, Rocha FG, Kingham TP, Fong Y, D’Angelica MI, Jarnagin WR, DeMatteo RP, Allen PJ. Hepatic arterial nodal metastases in pancreatic cancer: Is this the node of importance? J Gastrointest Surg. 2013;17(6):1092-7.

LaFemina J, Katabi N, Klimstra D, Correa-Gallego C, Gaujoux S, Kingham TP, DeMatteo RP, Fong Y, D’Angelica MI, Jarnagin WR, Do RK, Brennan MF, Allen PJ. Malignant progression in intraductal papillary mucinous neoplasms of the pancreas. Ann Surg Oncol. 2013;20(2):440-7.

 Whalen G, Sullivan M, Piperadi B, Wassef W, Galili U. Cancer immunotherapy by intratumoral Injection of α-gal glycolipids. Anticancer Res. 2012;32(9):3861-8.

O’Neill CB, Atoria CL, O’Reilly EM, LaFemina J, Henman MC, Elkin EB. Costs and trends in pancreatic cancer treatment: A population-based analysis. Cancer. 2012;118(20):5132-9.

Presentations

Dinh K, Bathini V, Switzer B, Kasturi V, Wassef W, Zivny J, Sullivan M, Whalen G, LaFemina J. Ampullary and Extraampullary Duodenal Adenocarcinomas Have Comparable Survival After Potentially Curative Resection. Poster Presentation. Massachusetts Chapter of the American College of Surgeons, Boston, MA, December 7, 2013.

Lim P, Sullivan M, Wassef W, Zivny J, LaFemina J. 30 Day Outcomes Underestimated Endocrine and Exocrine Insufficiency After Pancreatic Resection. Oral Presentation. Massachusetts Chapter of the American College of Surgeons, Boston, MA, December 7, 2013.

Lim P, Sullivan M, Wassef W, Zivny J, LaFemina J. 30 Day Outcomes Underestimated Endocrine and Exocrine Insufficiency After Pancreatic Resection. Poster Presentation. American Pancreatic Association, Miami, FL, October 31, 2013.

Collins C, McDade T, Santry H, Movahedi B, Emhoff T, Whalen G, LaFemina J, Dorfman J. Adequacy of Patients Education Regarding Abdominal Incidentalomas in Trauma Patients: A One-Year Review. Oral Presentation. NESS 94th Annual Meeting, September 20-22, 2013.

Frankel TL, LaFemina J, D’Angelica M, DeMatteo RP, Fong Y, Kingham TP, Jarnagin WR, Allen PJ. Dysplasia at the surgical margin predicts recurrence following the resection of non-invasive IPMN. President’s Plenary Oral Presentation and Recipient of the Young Investigator Award. 13thAnnual AHPBA Annual Meeting. Miami Beach, FL. February 21, 2013.

LaFemina J, Correa-Gallego C, Gaujoux S, Kingham TP, DeMatteo RP, Fong Y, D’Angelica MI, Jarnagin WR, Katabi N, Do RK, Brennan MF, Allen PJ. Malignant progression in intraductal papillary mucinous neoplasms of the pancreas. Poster. Massachusetts Chapter of the American College of Surgeons, Boston, MA, December 1, 2012.

Frankel T, LaFemina J, D’Angelica MI, Fong Y, Kingham TP, DeMatteo RP, Brennan MF, Jarnagin, WR, Allen PJ. Parenchymal-preserving pancreatectomy for intraductal papillary mucinous neoplasms. Poster. American College of Surgeons, Chicago, IL, October 3, 2012.

LaFemina J, Correa-Gallego C, Gaujoux S, Kingham TP, DeMatteo RP, Fong Y, D’Angelica MI, Jarnagin WR, Katabi N, Do RK, Brennan MF, Allen PJ. Malignant progression in intraductal papillary mucinous neoplasms of the pancreas. Poster. New York Cancer Society, New York, NY, May 16, 2012.

LaFemina J, Correa-Gallego C, Gaujoux S, Kingham TP, DeMatteo RP, Fong Y, D’Angelica MI, Jarnagin WR, Katabi N, Do RK, Brennan MF, Allen PJ. Malignant progression in intraductal papillary mucinous neoplasms of the pancreas. Oral Presentation. Society of Surgical Oncology’s 65th Annual Cancer Symposium, Orlando, FL, March 23, 2012.

Correa-Gallego C, LaFemina J, D’Angelica M, DeMatteo R, Kingham P, Fong Y, Jarnagin WR, Allen PJ. Indications, Technique and Outcomes for Central Pancreatectomy: An Updated Experience. Mini Oral Presentation. 12th Annual AHPBA Annual Meeting. Miami Beach, FL, March 11, 2012.

LaFemina J, Correa-Gallego C, Chou JF, Gonen M, Kingham TP, DeMatteo RP, D’Angelica M, Jarnagin WR, Allen PJ. Hepatic arterial nodal metastases in pancreatic cancer: Is it the node of importance. Oral Poster. 12th Annual AHPBA Annual Meeting. Miami Beach, FL, March 9, 2012.

LaFemina J, Correa-Gallego C, Gaujoux S, Kingham TP, DeMatteo RP, Fong Y, D’Angelica MI, Jarnagin WR, Katabi N, Do RK, Brennan MF, Allen PJ. Malignant progression in intraductal papillary mucinous neoplasms of the pancreas: Results of 157 patients initially selected for radiologic surveillance. Oral Presentation and Poster. 2012 Gastrointestinal Cancers Symposium, San Francisco, CA, January 20, 2012.

O’Neill CB, Atoria CL, O’Reilly EM, LaFemina J, Elkin EB. Costs and trends in pancreatic cancer treatment: A population-based analysis. Poster. 2011 ASCO Annual Meeting, Chicago, IL, June 3-7, 2011.

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