At the 20th Annual Hirshberg Symposium, Dr. Margaret Tempero, the Director of the Cancer Early Detection and Interception Initiative and the leader of the Pancreas Center Program at the UCSF Helen Diller Family Comprehensive Cancer Center, gave a wonderful overview of her work and how it’s now focused on Prevention and Surveillance for Pancreatic Cancer.
Risk Factors & Surveillance for High-Risk Individuals
There are multiple risk factors that have been associated with pancreatic cancer, some that can be controlled like smoking and alcohol use and others such as family history that are outside of one’s control. For high risk individuals, those with a strong family history of pancreatic cancer or who have a diagnosed genetic mutation is genes associated with hereditary pancreatic cancer, the NCCN guidelines recommend screening and surveillance to increase early detection in these people. Additionally, programs such as The Pancreatic Cancer Early Detection (PRECEDE) Consortium foster collaboration across institutions and aim to study a large number of high-risk individuals with the goal to understand and stratify patient risk and provide information to guide clinical decision making.
The CEDI Initiative
Except for people with certain hereditary predispositions, there is currently no screening for pancreatic cancer for the general public and this is similar for most types of cancer. To address that unmet need, Dr. Tempero created the Cancer Early Detection and Interception (CEDI) Initiative at UCSF with the goal of eliminating the burden of deadly cancers through more efficient early detection.
The CEDI initiative is evaluating rational, cost-effective, and equitable ways to increase early detection and these include explorations of imaging technologies, artificial intelligence, biomarker discovery, and education and outreach. Their Cancer Diagnostic Service exists to support anyone who has a potential cancer signal to get the appropriate tests and care in a knowledgeable and efficient manner.
Tools for Earlier Detection
The ability to stratify the general population into risk groups for potential screening would increase the ability to detect cancer earlier in patients without a hereditary or genetic predisposition for pancreatic cancer. There are multiple initiatives being developed and validated to help achieve this. One tool under development is blood-based screening for cancers.
Blood-Based Screening
PancreaSure (Immunovia) and Avantect (Clearnote) are two such tests specific to pancreatic cancer which are being optimized in the hopes to detect pancreatic cancer early, when treatment options are more favorable for resection.
Multi-Cancer Detection (MCD)
There are also mutli-cancer detection (MCD) tests such as Galleri (Grail) and Cancer Guard (Exact Sciences) that are under development and being tested in clinical trials for eventual use for this purpose.
Other tools include using artificial intelligence (AI) to identify clinical patterns or radiographic evidence of pancreas dysfunction in large data sets to speed up identifying people who may be at high risk for developing pancreatic cancer.
Due, in part, to the initiatives that Dr. Tempero and others have focused on, she believes that the ability to identify high-risk individuals with no family predisposition is fast approaching. This means the potential for earlier and more actionable diagnosis of patients with pancreatic cancer and the power to increase quality of life and survival for those individuals. The Hirshberg Foundation is proud to fund research that will increase early detection and to be part of the PRECEDE Consortium through The Agi Hirshberg Center for Pancreatic Diseases at UCLA.
