Hepatobiliary-Pancreatic and Gastrointestinal Surgery News

Major Grant Fuels Pancreas Cancer Research

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Surgeon William Hawkins, MD, right — shown here with surgery research fellows Linda Jin, MD, and Darren Cullinan, MD — is among several faculty performing pancreatic cancer research funded by a $10.4 million SPORE grant.

Pancreatic ductal adenocarcinoma (PDAC), the most common form of pancreas cancer, remains a grim diagnosis. Only 6 percent of patients survive five years, and 73 percent of patients don’t see the first anniversary of their diagnosis. Yet William Hawkins, MD, reports some progress: Five-year survival has increased by 2 percent in recent years, and many of his patients with advanced disease live two to four years after diagnosis.

Hawkins, the Neidorff Family and Robert C. Packman Professor and chief of the Section of Hepatobiliary-Pancreatic and Gastrointestinal Surgery, has further cause for hope. A Team Science Award from the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine enabled Hawkins and other researchers to begin work on promising drug development and immunotherapy projects. Then, in June 2016, he and his colleagues received a Specialized Programs of Research Excellence (SPORE) grant of $10.4 million, a major collaborative translational research award sponsored by the National Cancer Institute.

The SPORE grant will fund four projects, each resulting in a clinical trial:

  • Developing and testing personalized vaccines for PDAC patients based
    on their genetic factors
  • Evaluating a method to overcome immune suppression caused by tumors
  • Screening combinations of drugs for inhibiting molecular pathways that foster tumor survival
  • Developing a delivery platform that sends small-molecule drugs directly to tumors and avoids adverse side effects

Hawkins is principal investigator of the grant, which includes researchers at Washington University and other institutions in the United States and Europe.

The grant includes a biostatistics core, led by public health sciences Division Chief Graham Colditz, MD, DrPH, and biostatistician Esther Lu, PhD; and a tissue repository core to provide tissue samples, led by surgeon Ryan Fields, MD. The grant also funds other pancreatic cancer research projects and a career development program for junior researchers on the path to pancreas cancer research.

“As we better understand the tumor biology, we may start to see real progress in the median survival rate,” says Hawkins. “The immunotherapy projects could potentially be quite transformative.”


Highlights

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Resident Bradley Krasnick, MD, left, and Ryan Fields, MD

Ryan Fields, MD, is collaborating with Robert Schreiber, PhD, Alumni Endowed Professor of Pathology and Immunology, and Christopher Maher, PhD, assistant director of the Elizabeth H. and James S. McDonnell III Genome Institute, to develop a humanized mouse model that combines a patient’s own tumor and immune system in a mouse host. Fields’ lab will test various immunotherapies in the mice and compare the responses to how the patient responds to standard immunotherapies. If the mouse model is an effective predictor of response to immunotherapies, it could be used to determine the best treatment for patients with melanoma and other cancers.

In research studies comparing results of various liver operations, an important factor is the complexity of the surgery. Yet, since the 1950s, liver surgery only has been classified as minor or major. Steven Strasberg, MD, and colleagues have developed a classification system to support these comparative studies. The system, published in the Journal of the American College of Surgeons, allows for separation of liver resections into three categories of complexity on a quantitative basis.

Dirk Spitzer, PHD, is exploring a plan to commercialize a redesigned drug to improve treatment for women who have ovarian cancer.

Section Chief William Hawkins, MD, received a grant to develop a pancreas cancer vaccine that targets mesothelin, a protein that is overexpressed in pancreatic cancer.