“La generosidad y la visión de futuro de la Cayton Goldrich Family Foundation brindaron los recursos para realizar labor de difusión y coordinar la atención de estos pacientes”, señaló Cristina Ferrone, MD, jefa del Departamento de Cirugía Jim and Eleanor Randall de Cedars-Sinai. “Al reunir a nuestros médicos y reclutar al mejor talento de todo el país, estamos haciendo de este centro centralizado de BRCA algo único”.

Las personas de ascendencia judía asquenazí, así como aquellas con antecedentes familiares de cáncer de mama, ovario, próstata o páncreas, o quienes hayan sido diagnosticadas con alguno de estos tipos de cáncer, deben someterse a pruebas de detección de las mutaciones BRCA1 y BRCA2, señaló Ferrone.

Detección de Cáncer

“Este centro ofrecerá todos los servicios pertinentes: evaluación integral de riesgo, vigilancia de vanguardia, estrategias de prevención, ensayos clínicos y acceso a los últimos descubrimientos científicos”, afirmó Farin Amersi, MD, oncóloga quirúrgica que trata a pacientes con mutaciones de BRCA. “Más importante aún, creará un verdadero hogar para los pacientes y las familias que enfrentan el riesgo de cáncer hereditario”.

La primera visita de un paciente al centro comienza con asesoramiento genético para ayudarle a comprender su riesgo particular de cáncer. Para las mujeres, la visita inicial también incluye una resonancia magnética de mama o mamografía, además de una ecografía pélvica y un análisis de sangre para detectar cáncer de ovario. Los hombres se someten a estudios de imagen para detectar cáncer de mama, así como a un examen y análisis de sangre para detectar cáncer de próstata. En el caso del cáncer de páncreas, tanto hombres como mujeres pueden someterse a estudios de imagen abdominal y conversar sobre la posibilidad de una endoscopía de detección, según su riesgo individual.

“En muchas otras instituciones, los pacientes diagnosticados con una mutación de BRCA deben programar citas por separado para cada una de estas pruebas, con distintos médicos”, dijo Amersi. “Nuestros pacientes realizarán todas sus pruebas de detección, y recibirán sus resultados, en una sola visita. Esto ayudará a aliviar la ansiedad de tener que coordinar múltiples citas y esperar para conocer los resultados de estas pruebas”.

El proceso condensa en un solo día lo que podrían ser entre ocho y 12 citas distintas, dijo Ferrone.

“Para los pacientes con mutaciones de BRCA, estas pruebas de detección se repiten cada seis a 12 meses, por lo que pueden imaginar lo disruptivo que resultan las citas separadas para los pacientes, muchos de los cuales trabajan y tienen familia”, dijo Ferrone.

De acuerdo a los resultados de sus pruebas, los pacientes se reúnen con un equipo de especialistas para definir el mejor camino a seguir, teniendo en cuenta la edad del paciente, sus objetivos de fertilidad y su riesgo individual de cáncer.

Tratamiento Preventivo

Para la prevención del cáncer de mama y de ovario, los pacientes y su equipo de atención conversan sobre la necesidad y el momento oportuno de una posible cirugía preventiva.

Las mutaciones BRCA1 y BRCA2 conllevan riesgos ligeramente distintos, dijo Marla Scott, MD, oncóloga ginecológica.

“Las personas con mutaciones BRCA1 tienen un riesgo aproximadamente 40% mayor de cánceres ginecológicos, y suelen presentarlos a una edad promedio más temprana”, dijo Scott. “Esto significa que conversamos sobre la extirpación de las trompas de Falopio y los ovarios, así como sobre la consideración de una histerectomía y mastectomía, entre los 35 y los 40 años”.

Un endocrinólogo reproductivo está disponible en el centro para conversar sobre la preservación de la fertilidad, incluyendo la congelación de óvulos y embriones y la fertilización in vitro, así como sobre opciones de terapia hormonal sustitutiva para manejar los síntomas de la menopausia inducida quirúrgicamente, comentó Scott.

Para las personas con mutaciones BRCA2, el aumento del riesgo de cáncer ginecológico es ligeramente menor, y la edad de aparición del cáncer suele ser unos 10 años más tardía, lo que permite a los médicos posponer las cirugías preventivas, dijo Scott.

“Con excepción de los exámenes regulares de mama, los pacientes pueden llegar a ‘graduarse’ de las pruebas de detección de cánceres ginecológicos si se someten a una cirugía de reducción de riesgo y no muestran signos de cáncer”, dijo Scott.

Scott añadió que, si bien manejar el riesgo de cáncer puede ser difícil para las personas con una mutación de BRCA, contar con un lugar al que acudir en busca de orientación resulta empoderador. La esperanza, dijo Ferrone, es que los esfuerzos de difusión comunitaria lleven estos beneficios a un número aún mayor de pacientes.

“Tenemos la enorme fortuna de poder ofrecer pruebas genéticas gratuitas en poblaciones de alto riesgo en un futuro cercano”, dijo Ferrone. “Esto nos ayudará a identificar a más pacientes en riesgo e inscribirlos en los programas adecuados para ayudarlos a manejar su riesgo y preservar su salud”.

La Universidad de Ciencias de la Salud de Cedars-Sinai está impulsando investigaciones innovadoras y formando a los futuros líderes en medicina, ciencias biomédicas y ciencias de la salud afines. Más información sobre la universidad.

Breast tumors are currently classified into basic subtypes such as HER2-positive and triple-negative. Based on a tumor’s subtype, doctors can prescribe chemotherapy, immunotherapy or other treatments to shrink the tumor before a patient undergoes surgery to remove it. This can allow some patients to have a lumpectomy rather than a full mastectomy.

Presurgical treatment, also called neoadjuvant treatment, can also help kill cancer cells that have spread beyond the breast, which can help prevent cancer from returning.

“The issue is that a single breast tumor can include many cancer subtypes, but current tests classify the whole tumor as one,” said Eytan Ruppin, MD, PhD, deputy director of the Translational Research Institute at Cedars-Sinai and co-corresponding author of the study. “With BRIDGE, we use gene activity to measure the various subtypes within a tumor and better pair patients with the most effective presurgical treatment.”

Together with the composition of the tumor, BRIDGE provides a score that tells clinicians how likely a patient is to respond to a given presurgical treatment. The tool analyzes the same tumor biopsy samples physicians routinely take when a patient is diagnosed.

“We addressed the most common presurgical treatments given in the major breast cancer subtypes,” said Thomas Cantore, PhD, a postdoctoral scientist in the Ruppin lab and co-corresponding author of the study. “Applying BRIDGE to data from hundreds of patient samples whose cancer type and treatment response were known, we found that it accurately predicts which patient may or may not respond to which therapy.”

Building on the work of others on Ruppin’s team, the investigators next took BRIDGE a step further.

“Our second step was to apply AI tools to BRIDGE to create BRIDGE-Slide,” said Nishanth Ulhas Nair, PhD, a research scientist in the the Jim and Eleanor Randall Department of Surgery and co-corresponding author of the study. “Rather than requiring costly genomic sequencing of the tumor, BRIDGE-Slide can infer the makeup of a tumor from an image of the biopsy slide. This saves time, and thousands of dollars, and could help democratize precision oncology, making personalized breast cancer treatment accessible to all.”

The next step for investigators is to further test BRIDGE and BRIDGE-Slide in clinical trials, Cantore and Nair said.

“These biopsy slides are a gold mine of information,” Cantore said, “and we are focused on leveraging them.”

Additional Cedars-Sinai authors include S.R. Dhruba, E. Campagnolo, J. Levy, K. Yao, I. Liao, and Y. Yuan.

Other authors include D-T. Hoang, L.R. Pal, A. Stemmer, T-G. Chang, E. Shulman, J.S. Lee, S.M. Stemmer, S-J. Sammut, S. Lipkowitz, P.S. Rajagopal, M. Filipits, and C. Caldas.

Funding: This research was supported in part by the Intramural Research Program of the National Institutes of Health (NIH), National Cancer Institute (NCI). The contributions of the NIH author(s) are considered Works of the United States Government. The findings and conclusions presented in this paper are those of the author(s) and do not necessarily reflect the views of the NIH or the U.S. Department of Health and Human Services. This research is partially supported by a grant of the Korea-US Collaborative Research Fund (KUCRF), funded by Ministry of Science and ICT and Ministry of Health & Welfare, Republic of Korea (grant number: RS-2024-00468417). This work used the computational resources of the NIH HPC Biowulf cluster (http://hpc.nih.gov). The results shown here are in part based upon data generated by the TCGA Research Network: https://www.cancer.gov/tcga.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

The new

“The generosity and foresight of the Cayton Goldrich Family Foundation gave us the resources to conduct outreach and coordinate care for these patients,” said Cristina Ferrone, MD, chair of the Jim and Eleanor Randall Department of Surgery at Cedars-Sinai. “By bringing together our dedicated physicians and recruiting top talent from around the country, we are making this centralized BRCA center unlike any other.”

Individuals of Ashkenazi Jewish descent, and those with family history of breast, ovarian, prostate or pancreatic cancer, or people who have been diagnosed with one of these cancers, should be screened for BRCA1 and BRCA2 mutations, Ferrone said.

Cancer Screenings

“This center will provide every relevant service: comprehensive risk assessment, state-of-the-art surveillance, prevention strategies, clinical trials, and access to the latest scientific discoveries,” said Farin Amersi, MD, a surgical oncologist who treats patients with BRCA mutations. “More importantly, it will create a true home for patients and families facing hereditary cancer risk.” 

A patient’s first visit to the center begins with genetic counseling to help patients understand their unique cancer risk. For women, the initial visit also includes a breast MRI or mammogram, and a pelvic ultrasound and blood test to screen for ovarian cancer. Men undergo imaging to screen for breast cancer and an exam and blood test to screen for prostate cancer. For pancreatic cancer, both men and women may have abdominal imaging and discuss the possibility of endoscopy screening, depending on their individual risk.

“At many other institutions, patients diagnosed with a BRCA mutation have to make appointments for each of these screenings separately, with different physicians,” Amersi said. “Our patients will have all their screenings—and receive their test results—in one visit. This will help relieve the anxiety of juggling multiple appointments and waiting to learn the results of these tests.”

The process condenses what could be eight to 12 different appointments into a single day, Ferrone said.

“For patients with BRCA mutations, these screenings are repeated every six to 12 months, so you can imagine how disruptive separate appointments are for patients, many of whom work and have families,” Ferrone said.

Based on their test results, patients meet with a team of specialists about the best path forward, taking into account the patient’s age, fertility goals and individual cancer risk.

Preventive Treatment

For breast and ovarian cancer prevention, patients and their care team discuss the need and timing for possible preemptive surgery.

BRCA1 and BRCA2 mutations have slightly different risks associated with them, said Marla Scott, MD, a gynecologic oncologist.

“People with BRCA1 mutations have roughly a 40% higher risk for gynecologic cancers, and are a younger average age when cancer tends to appear,” Scott said. “This means we have a discussion about removing the fallopian tubes and ovaries, as well as consideration for hysterectomy and mastectomy, between ages 35 and 40.”

A reproductive endocrinologist is on-site to discuss fertility preservation—including egg and embryo freezing and in-vitro testing and fertilization—as well as hormone replacement options to manage symptoms of surgically-induced menopause, Scott said.

For people with BRCA2 mutations, there is a slightly lower increased risk of gynecologic cancer, and age of cancer onset tends to be about 10 years later, allowing doctors to delay preventive surgeries, Scott said.

“With the exception of regular breast exams, patients may get to ‘graduate’ out of further screening for gynecologic cancers if they have a risk-reducing surgery and show no signs of cancer,” Scott said.

Scott added that while managing cancer risk can be challenging for people with a BRCA mutation, having a place they can go for guidance is empowering. The hope, Ferrone said, is that community outreach efforts will bring these benefits to even more patients.

“We are incredibly fortunate to be able to offer free genetic testing in high-risk populations in the near future,” Ferrone said. “This will help us identify more at-risk patients and get them enrolled in the appropriate programs to help them manage their risk and preserve their health.”

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Andrew Hendifar, MD, professor of Medicine and medical director of the Cancer Clinical Trials Office and the Gastrointestinal Oncology Disease Research Group at Cedars-Sinai, was a principal investigator on the trial and a co-author of the study, which was sponsored by Revolution Medicines, makers of the new drug. He sat down with the Cedars-Sinai Newsroom to talk about the study results.

How does this new drug work?

The medication, called daraxonrasib, is the first drug that targets cancer-causing mutations in pancreas cells.

The drug targets a mutation in the KRAS gene, part of the RAS genetic family. KRAS mutations are present in 92% of pancreatic cancers. KRAS genes normally act as an “on-off” switch for cell growth. Mutated KRAS genes are stuck in the “on” position and send out a signal that causes cells to divide and grow uncontrollably, allowing cancer to form.

Daraxonrasib blocks the KRAS signal by fitting into a keyhole-type spot on the gene. That spot has a complex shape and is difficult to reach within the cell. The drug gets around this problem by using a “passenger protein” as a Trojan horse. When the cell allows this protein in, daraxonrasib tags along.

Why are these clinical trial results so groundbreaking?

There are no targeted treatments approved for pancreas cancer, and we haven’t had any significant progress for a long time. We've only come up with different chemotherapy combinations, and those are only moderately effective. This new treatment is staggeringly better than chemotherapy. Usually, when we think of an improvement in pancreatic cancer survival, we think of 25% improvement. This medication actually doubled survival in patients with advanced disease. We have patients who participated in the trial who are still alive, which is unheard of because the five-year survival rate for pancreatic cancer patients is only 13%-14%. If the drug is approved by the FDA, it will most likely become the new standard of care for advanced pancreatic cancer and could replace chemotherapy as a first-line treatment.

What comes next?

We are now testing the drug in patients with earlier-stage pancreatic cancer, prescribing it while their tumors are still operable and before their cancer spreads.

Could daraxonrasib be effective against other cancer types?

RAS mutations are one of the most common cancer-causing genetic mutations, and the drug is now being studied in several cancer types. I think it's going to work especially well in tumors that are primarily RAS driven, including colon cancer and lung cancer. It might also work in other cancer types in combination with drugs targeting other genetic mutations, but further research is needed.

How will this discovery change cancer science?

This is a win for the field. Until now we have been focused on immune therapies that might make tumors more vulnerable to the body’s immune system, and on finding new chemotherapy combinations that kill cancer cells.

This new treatment has given us a new focus, and I think it will spur a lot of scientific discovery over the next few years. There have only been a handful of KRAS researchers and their relevance to therapy was always questioned. That is about to change.

The most important next step for the field is to better understand the biology of cancer. We know that many pancreatic tumors will eventually become resistant to daraxonrasib, and we need to understand how this happens. We also need to identify additional genetic pathways and treatments that can target them. That’s how we will turn pancreas cancer from a deadly, deadly cancer into something we can manage—and one day, even cure.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Andrew Hendifar, MD, medical director of the Cedars-Sinai Cancer Clinical Trials Office and professor of Medicine, is available to discuss late-breaking, embargoed results of a trial of a new therapy for advanced pancreatic cancer, as well as Phase II results from a trial of a combination therapy that targets specific genetic mutations in pancreatic cancer cells.

Additional Cedars-Sinai Experts

Leslie Ballas, MD, professor of Radiation Oncology, will participate in a panel discussion and can discuss evidence related to use of biomarkers or circulating tumor DNA in treatment decisions for patients with muscle-invasive bladder cancer.

Fahima Dossa, MD, PhD, a surgical oncologist, will present research on which patients with high-risk localized soft tissue sarcoma are most likely to benefit from chemotherapy.

Stephen Freedland, MD, director of the Center for Integrated Research in Cancer and Lifestyle, will present a post hoc analysis of the EMBARK trial in advanced prostate cancer, detailing testosterone recovery following treatment suspension. Freedland can also discuss research from his lab on use of olaparib, an enzyme blocker, in metastatic castration-resistant prostate cancer, and statin use in prostate cancer patients receiving hormone treatment after prostate-removal surgery.

Lawrence Liu, MD, a hematology oncologist, will present research on recent advances in CAR T-cell therapies for patients with relapsed multiple myeloma. The work involves mezigdomide, part of a new drug class in myeloma, following infusion with idecabtagene vicleucel, a genetically modified CAR T therapy derived from the patient’s own cells.

Arsen Osipov, MD, associate professor of Medicine and medical director of Pancreatic Cancer, can discuss research from his lab on the comprehensive molecular profiles associated with variants of the KRAS gene and patient survival in pancreatic cancer. KRAS mutations are found in more than 90% of pancreatic cancer cases.

Karen Reckamp, MD, professor of Medicine and director of the Division of Medical Oncology, can discuss the treatment landscape for non-small cell and small cell lung cancer. She can explain research from her lab on a machine learning approach for predicting immune-related pneumonitis, a noninfectious lung inflammation that can occur following treatment with immune checkpoint inhibitors. She can also speak about new data from Lung MAP, a clinical trial designed to efficiently test treatments for advanced non-small cell lung cancers. And she will make a presentation on support of academic nonclinical efforts for cancer investigator faculty at the Association of American Cancer Institutes.

Kamya Sankar, MD, assistant professor of Medicine and co-director of the Thoracic Disease Research Group, will present an analysis of factors associated with early cachexia—also known as cancer wasting disease—in metastatic non-small cell lung cancer. She can also speak about treatment of both non-small cell and small cell lung cancer.

From The Angeles Clinic and Research Institute

Mark Faries, MD, surgical oncologist and professor of Surgery, can discuss a five-year update from the KEYNOTE-942 study in resected melanoma and a new study of lymph node resection versus therapeutic dissection in advanced melanoma, as well as recurrence in advanced melanoma across time.

Erwin Grussie, MD, a hematology oncologist, can discuss results from the Targeted Agent and Profiling Utilization Registry (TAPUR) study testing targeted therapies in patients with solid tumors.

Omid Hamid, MD, professor of Medicine and chief of Translational Research and Immuno-Oncology, will present results from a study of a medication that blocks the action of cortisol in patients with advanced solid tumors, as well as a study of causes of limited immunotherapy response in melanoma. He can also discuss new results from three trials of therapies in advanced melanoma.

Inderjit Mehmi, MD, a hematology oncologist, can discuss the association of prior immunotherapy treatment with limited response to subsequent immunotherapy in melanoma.

Media Contact

To schedule an interview, contact Christina Elston at christina.elston@cshs.org or 626-298-0702.

The new tool, called Path2Space, predicts gene expression across the tumor area based on digital images of biopsy slides, which contain thin slices of tumor tissue that can be examined under a microscope.

Because tumors do not have the same composition and gene expression throughout, Path2Space predicts what is known as “spatial” gene expression, estimating it at many different points within the tumor. The process takes only minutes and costs significantly less than conventional spatial gene expression profiling, which typically takes several weeks and costs thousands of dollars.

“This tool makes two major contributions,” said Eytan Ruppin, MD, PhD, deputy director of the Translational Research Institute at Cedars-Sinai and senior author of the study. “It will enable us and others to study larger datasets and understand the spatial structure of tumors. But what really motivates me is that, if we can successfully validate the tool in clinical trials, it could improve cancer care for patients.”  

Investigators “trained” Path2Space using data from a large group of patients with breast cancer, where the biopsy slides and spatial sequencing were both available. They then tested the tool on three additional patient datasets to validate its performance.

“For each sample, we looked at the actual, measured gene expression and compared it with our tool’s prediction,” said Eldad Shulman, PhD, co-first author of the study and a research fellow at the National Cancer Institute, who will soon join Ruppin's lab as a research scientist. “For each sample, we predicted the spatial expression of almost 5,000 genes, and the predictions matched the measured expression well across all three patient groups.”

Path2Space is also designed to help scientists discover new biomarkers that could guide treatment decisions and identify patients at higher risk of poor outcomes.  

“The tool looks at characteristics within the tumor, such as whether a gene is expressed in some areas of the tumor and not others,” said Emma Campagnolo, co-first author of the study and a research fellow in Ruppin’s lab. “We found specific spatial patterns of gene activity in tumors that predict how patients respond to treatment.”

Identifying spatial biomarkers is challenging, Shulman said, because the high cost of spatial profiling by traditional methods means very little of this data is available.

“Before we developed Path2Space, the largest cohort we could find to study the spatial organization of the tumor environment was about 30 patients,” Shulman said. “With this tool, we can study slides from thousands of patients. Path2Space is tapping into the potential of spatial biology in a way that has not been possible until now.”

Path2Space could be applied to other cancer types once it is trained on the correct data, and the lab is finalizing a study applying it to head and neck cancer, Campagnolo said. The team is also working to make the tool more precise. It currently looks at groups of 10 to 20 cells together, and the goal is to eventually be able to assess individual cells.  

“With the help of clinical collaborators, we next want to bring Path2Space into clinical trials,” Ruppin said. “It represents an exciting development in a growing field and has to be tested carefully. But we are hopeful that it could make an impactful contribution to science and to patient care.”

Robert Figlin, MD, interim director of Cedars-Sinai Cancer, noted that translational research is a hallmark of the institution.

“The development of tools that apply leading-edge science to patient care is the best way to serve our patients—and to improve cancer care on a global scale,” Figlin said.

Additional Cedars-Sinai authors include Yuan Yuan, Karine Sargsyan, and Simon R.V. Knott.

Other authors include Roshan Lodha, Youngmin Chung, Amos Stemmer, Thomas Cantore, Beibei Ru, Tian-Gen Chang, Sumona Biswas, Saugato Rahman Dhruba, Sumeet Patiyal, Sushant Patkar, Andrew Wang, Ranjan K. Barman, Chuhan Wang, Rohit Paul, Sarath Chandra Kalisetty, Tom Hu, MacLean P. Nasrallah, Ellis Patrick, Jean Yang, Amy Plotkin, Padma Sheila Rajagopal, Stephen-John Sammut, Stanley Lipkowitz, Peng Jiang, Carlos Caldas, Kenneth Aldape, Joo Sang Lee, and Danh-Tai Hoang.

Funding: This research was supported by the Intramural Research Program of the NIH, NCI, and the Center for Cancer Research. The contributions of the NIH authors were made as part of their official duties, as NIH federal employees are in compliance with agency policy requirements and are considered works of the U.S. government. This research was also partially supported by a grant of the Korea-United States Collaborative Research Fund, funded by the Ministry of Science and ICT and the Ministry of Health and Welfare, Republic of Korea (grant number: RS-2024-00468417; Y.C. and J.S.L.), and by an Institute of Information & Communications Technology Planning & Evaluation (IITP) grant funded by the Korea government (MSIT) (RS-2019-II190421, AI Graduate School Support Program, Sungkyunkwan University; Y.C. and J.S.L.). This work has utilized the computational resources of the NIH HPC Biowulf cluster.

Competing interests: E.D.S., E.M.C. and E.R. are listed as inventors on a provisional patent (application no. 63/703,060, United States, 2024) filed based on the methodology outlined in this study. E.R is (non-paid) member of the scientific advisory boards of Pangea Biomed (divested), GSK Oncology and the ProCan project. E.R is a founder of MedAware Ltd. The other authors declare no competing interests.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

If validated in further studies, the artificial intelligence-based platform could be used to improve treatment selection in virtually any cancer type. Results from a study of the platform’s effectiveness are published in the Journal of Clinical Oncology.

“Currently, we have no conclusive data to show which of the two approved chemotherapy regimens for patients with advanced pancreatic cancer is more effective,” said Andrew Hendifar, MD, medical director of Pancreatic Cancer at Cedars-Sinai Cancer and first author of the study. “So we start with one, do our best to quickly gauge the patient’s response, and switch if needed.”

The problem with this, Hendifar said, is that putting an ill patient on a chemotherapy regimen that isn’t working worsens their health rather than improving it. Biomarkers from blood or tissue can help predict treatment response and guide these decisions in other cancer types, but currently, no biomarkers exist for pancreatic cancer.

“This endeavor is an example of applying AI technology to an unmet clinical need, and offers tremendous translational potential,” said Robert Figlin, MD, interim director of Cedars-Sinai Cancer. “It aligns perfectly with our goal of personalizing cancer treatment for our patients and improving outcomes for all.”

To develop the tool, investigators used a platform called Computational Histology Artificial Intelligence, or CHAI. CHAI analyzes images of microscope slides containing samples of tumor tissue, which are stained to highlight minute details of the cells. Almost all patients have these samples taken when their tumors are biopsied.

The team analyzed tissue characteristics in samples from 25,000 pancreatic cancer patients who had received one chemotherapy regimen or the other. The platform’s AI capabilities made it possible to analyze more than 30,000 different features of the tissue samples. Investigators then matched tissue characteristics to treatment response to create the predictive tool.

When they tested the tool on data from a large clinical trial using the two pancreatic cancer treatment regimens, they found that it was able to accurately predict each patient’s response to the treatment received.

“Unlike most biomarker tests, where you need an extra sample of tissue or blood, this test requires only a scanned image of the patient’s existing biopsy slide,” Hendifar said. “You just send the image electronically and quickly receive a result with the treatment preference. And you don’t just learn which treatment is preferred. You learn how much more effective it is likely to be.”

The tool needs to be further validated in patients undergoing treatment before it is ready for clinical use, but Hendifar said that with that validation it could eventually be applied to other solid tumor types. It could even compare the potential benefit of different types of therapy, such as radiation therapy versus surgery.

“If the chance that a particular treatment will benefit a patient is 50-50, which is quite common in cancer therapy, then this may serve as a powerful tool to aid physician and patient decision-making,” Hendifar said. “And we can train the digital tool not just to choose between two available treatments, but to choose between multiple available treatments.”

Additional Cedars-Sinai authors include Brent K. Larson, DO; Vladimir Kazarov, MS; Natalie Moshayedi, BS; and Arsen Osipov, MD.

Other authors include Viswesh Krishna, BS; Vrishab Krishna, BS; Haochen Zhang, PhD; Katelyn Smith, BA; Kawther Abdilleh, PhD; Snehal Sonawane, MD; Akshay Neema, MS; Asit Tarsode, MS; Ekin Tiu, MS; Vivek Nimgaonkar, MD; Shawn Hutchinson, MSc; Daniela Bevacqua, BS; Sudheer Doss, PhD; Alejandra Alvarez, MS; Drew Watson, PhD, MBA; Waleed M. Abuzeid, MD; Barbara T. Grunwald, MD; Marcus Noel, MD; Rashmi Samdani, MD; Dove Keith, PhD; Rosalie C. Sears, PhD; Davendra Sohal, MD, MPH; Christos Fountzilas, MD; Grainne M. O’Kane, MD; Robert C. Grant, MD, PhD; Eric A. Collisson, MD; Lesli A. Kiedrowski, MS, MPH; Trevor J. Royce, MD, MS, MPH; Anirudh R. Joshi, MS; Aatur D. Singhi, MD, PhD; and Jennifer J. Knox, MD, MSc.

Funding: Supported in part by the Pancreatic Cancer Action Network (PanCAN - Know Your Tumor), the University Health Network, Toronto (COMPASS trial), and Valar Labs, Inc.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Cedars-Sinai has received a $30 million gift from the Cayton Goldrich Family Foundation to establish the Cedars-Sinai Cayton BRCA Center, a first-of-its-kind in Southern California. The state-of-the-art center will concentrate on the research, diagnosis and comprehensive treatment of illnesses linked to mutations in the genes known as BRCA1 and BRCA2.

These genes, when functioning properly, help repair damaged DNA to prevent tumors from forming. However, mutations in the genes can significantly increase the risk of certain inherited cancers, including breast, ovarian, prostate and pancreatic malignancies.

“We can help prevent harmful BRCA mutations from being passed down from carriers to their children and grandchildren and work toward ending the cycle of inherited cancer risk,” said foundation trustee Barry Cayton.

Trustee Andrea Goldrich Cayton added, “Our family has personally been affected by BRCA gene mutations, so we feel especially compelled to make a transformative mark in the healthcare space linked to holistic BRCA research and care.”

The Cayton and Goldrich families are longtime supporters of Cedars-Sinai. In 2019, the Goldrich Family Foundation donated $10 million to establish the Jona Goldrich Center for Alzheimer's and Memory Disorders at Cedars-Sinai. The center was named for the late patriarch of the Goldrich family, who was a Holocaust survivor and prominent Los Angeles real estate developer and philanthropist.

“Cedars-Sinai is truly humbled and honored by our continued visionary partnership with the Cayton Goldrich Family Foundation,” said Peter L. Slavin, MD, president and CEO of Cedars-Sinai and the David and Meredith Kaplan Presidential Chair. “They embody humanitarianism and hold a strong belief in science’s ability to transform healthcare and improve human life.”

About 1 in 400 people in the U.S. carry a BRCA mutation. Males are less likely to be tested for the mutations, and female carriers are more likely to be diagnosed with breast cancer. BRCA mutations increase cancer risk in both genders, but the specific forms of cancer and rates of diagnoses differ.

Some population groups are more prone to BRCA mutations, including people of Eastern European Jewish, Korean, Mexican, and African American ancestries. Currently, there is no comprehensive BRCA clinical and research center in Los Angeles to serve high-risk communities. Cedars-Sinai leaders said the new center will play a major role in advancing research, education and clinical innovation.

“The Cedars-Sinai Cayton BRCA Center will offer patients personalized guidance and timelines for their care, including risk-reducing procedures, genetic testing, specialized screenings and reproductive medicine services to help break the cycle of genetic cancer risk,” said Shlomo Melmed, MB, ChB, executive vice president of Medicine and Health Sciences, dean of the Medical Faculty and the Helene A. and Philip E. Hixon Distinguished Chair in Investigative Medicine. “We will develop a hub of translational discovery science devoted to eradicating the cellular underpinnings of BRCA mutations.”

Read more on the Cedars-Sinai Blog: 7 Tips to Reduce Your Breast Cancer Risk

The combination therapy, which adds a drug called enzalutamide to commonly prescribed hormone therapy, reduced deaths in patients with recurrent prostate cancer after surgery or radiation for whom other treatments are no longer an option. The trial results were published in The New England Journal of Medicine (NEJM) with simultaneous presentation during the European Society for Medical Oncology Congress (ESMO) Oct. 19 in Berlin.

“After initial treatment, some patients see their prostate cancer come back in an aggressive way and are at risk for their disease to spread quickly,” said Stephen Freedland, MD, director of the Center for Integrated Research in Cancer and Lifestyle at Cedars-Sinai Cancer and co-principal investigator of the study. “Hormone therapy, which is what we’ve been offering patients for 30 years, has not improved survival and neither has anything else. That makes these findings a real game changer.”

The trial included more than 1,000 patients from 244 sites in 17 countries. All the patients were diagnosed with what is known as high-risk biochemically recurrent prostate cancer. Following the patients’ surgery or radiation therapy, the levels of prostate specific antigen, or PSA, in their blood had risen rapidly. PSA is a protein used to detect prostate cancer, and a rapid rise in PSA levels after treatment indicates a patient’s cancer is likely to return and spread—often to the bones or spine.

“We know these patients are at high risk of developing metastatic disease and dying of their cancer unless we offer a meaningful treatment option,” said Freedland, professor of Urology and the Warschaw, Robertson, Law Families Chair in Prostate Cancer.

Patients were randomly selected to receive standard hormone therapy alone, enzalutamide alone, or a combination of the two. After eight years, the risk of death was 40.3% lower in the combination group than in the other two groups, Freedland said.

“This clinical trial, one of many that Cedars-Sinai Cancer has offered to its patients, is an example of the translational work being done by our physician-scientists,” said Robert Figlin, MD, interim director of Cedars-Sinai Cancer. “The result will be improved treatment and better outcomes for patients everywhere.”

Freedland noted that, based on previous results published by the team, enzalutamide is approved by the Food and Drug Administration and listed in National Comprehensive Cancer Network treatment guidelines. These latest results, he said, are likely to strengthen the network’s recommendation and solidify this drug combination as the standard of care for patients with high-risk biochemically recurrent prostate cancer.

“These important findings identify a treatment that prolongs survival in men with aggressive prostate cancer,” said Hyung Kim, MD, a urologic oncologist and chair of the Department of Urology at Cedars-Sinai.  “The latest analysis complements previous studies that found enzalutamide significantly improved survival in other prostate cancer settings, and will change how we take care of our patients.”

Additional authors include Neal D. Shore, M.D.; Murilo de Almeida Luz, M.D.; Ugo De Giorgi, M.D., Ph.D.; Martin Gleave, M.D.; Geoffrey T. Gotto, M.D., M.P.H.; Christopher M. Pieczonka, M.D.; Gabriel P. Haas, M.D.; Choung-Soo Kim, M.D.; Miguel Ramirez-Backhaus, M.D.; Antti Rannikko, M.D., Ph.D.; Matko Kalac, M.D., Ph.D.; Swetha Sridharan, M.B.B.S.; Matt Rosales, Ph.D.; Yiyun Tang, Ph.D.; Ronald F. Tutrone Jr, M.D.; Balaji Venugopal, M.B.B.S., M.D.; Arnauld Villers, M.D., Ph.D.; Henry H. Woo, M.B.B.S., D.Med.Sc.; and Fong Wang, M.D., Ph.D.

Funding: The study was sponsored by Pfizer Inc. and Astellas Pharma Inc., the co‑developers of enzalutamide.

Disclosures: Stephen J. Freedland reports being a consultant to Astellas Pharma Inc., AstraZeneca, Bayer, Eli Lilly, Johnson & Johnson Innovative Medicine (formerly Janssen), Merck, Novartis, Pfizer Inc., Sanofi, Sumitomo Pharma America, Inc. (formerly Myovant Sciences, Inc.), and Tolmar.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

According to the Centers for Disease Control and Prevention, about 10 percent of new breast cancer cases in the U.S. are in women younger than 45.

“We don’t have routine screening recommendations for patients younger than 40, and people aren’t aware that if they have a strong family history, especially in a first-degree relative like a mother, sister or aunt, they should be screened sooner,” said Mary El-Masry, MD, the hematologist-oncologist who led Dade’s care team.

Dade, who received her care from an integrated team at Cedars-Sinai Cancer Beverly Hills, is dancing once again, but treatment for triple-negative breast cancer wasn’t easy. It began with a regimen known as KEYNOTE-522. The protocol included four types of chemotherapy medications to shrink the tumor, plus an immunotherapy drug to help Dade’s immune system do its part in fighting the cancer.

Also there to help were her mother and her partner, Marcus Mack.

“I really just kind of fell into the hands of my care team, knowing that this treatment regimen was going to be extremely rough,” Dade said. “I had moved in with Marcus only three months before I was diagnosed. And then my mom moved in. Who would have thought that my mother and my partner would both be taking care of me.”

Tumors like Dade’s are “negative” for three important receptors—estrogen, progesterone and HER2—that many treatments use to target tumors, making them among the most aggressive and challenging to treat. El-Masry called the protocol Dade received a “breakthrough” in the world of triple-negative breast cancer.

“Mataya has an excellent prognosis,” El-Masry said. “She had a complete clinical response to her treatment. We could see her tumor shrinking.”

Following her chemotherapy and immunotherapy regimen, Dade opted for a double mastectomy with reconstructive surgery. And as a social media influencer, she chose to document her treatment journey.

“This is a message to my future me that I am a baddie and I will get through cancer,” she said to her followers.

For young women like Dade, El-Masry said that it is important to seek out earlier screening if there is family history of cancer—and to be your own advocate.

“If you feel something, bring it to someone’s attention and push to have some imaging done,” El-Masry said. “That could mean a mammogram or, if you are concerned about radiation exposure, an ultrasound. And if imaging isn’t showing anything but you feel a lump, you should ask to have it biopsied so we can be sure it isn’t something we need to be concerned about.”

Several days after her surgery, Dade was able to post the news her friends and family had been waiting for: “I, Mataya Dade, am cancer free.”

With that, she is at work creating a podcast—supported by Mack, a composer and producer—called “You Survived! Now What?” The plan is to offer advice and create a community for other young cancer survivors who are taking their next steps in life—just like Dade and Mack are taking theirs.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Widely known as a pioneer in robot-assisted colorectal surgery, Pigazzi performed the world’s first robot-assisted tumor removal for rectal cancer more than 20 years ago. He has continued to advance the colorectal surgery field with his expertise in robot-assisted, laparoscopic and open surgical techniques to treat complex colorectal conditions such as recurrent and metastatic colorectal cancer.

Pigazzi brings to Cedars-Sinai a rich history of surgical leadership. Most recently, Pigazzi was division director of Colorectal Surgery at New York-Presbyterian/Weill Cornell Medical Center. He also was executive director for Surgical Services, vice chair of Clinical Network, and professor in the Department of Surgery at City of Hope Orange County.

In his new role at Cedars-Sinai, Pigazzi will concentrate on developing the academic colorectal practice, opening novel clinical trials and advancing translational research.

“Cedars-Sinai’s new Faculty Division of Colorectal Surgery will continue to build best-in-class, patient-centered care by staying on the forefront of the latest surgical techniques, clinical trials and clinical practices,” said Cristina Ferrone, MD, chair of the Department of Surgery at Cedars-Sinai. “Under Dr. Pigazzi’s esteemed leadership, we will also enrich our training programs as we develop the colorectal surgical leaders of tomorrow.”

In addition to his clinical practice, Pigazzi is involved in many significant research initiatives, including a translational research effort investigating the role dietary sugars play in the development of colorectal cancer. His extensive publication record includes more than 150 peer-reviewed articles and 16 book chapters. 

“Dr. Pigazzi’s innovative clinical work and research discovery for colorectal cancer aligns perfectly with our commitment to providing leading-edge expertise and care for our Cedars-Sinai Cancer patients,” said Robert Figlin, MD, interim director of Cedars-Sinai Cancer.  

Pigazzi earned both his medical and doctoral degrees at Boston University School of Medicine. He then completed his general surgery residency at New York-Presbyterian/Weill Cornell Medical College, followed by advanced fellowship training in minimally invasive surgery at Hackensack University Medical Center and in colorectal surgery at the University of California, Irvine.

“I’m grateful for the opportunity to bring my passion to this leadership role in the Department of Surgery at Cedars-Sinai,” Pigazzi said. “I look forward to growing the division to be the best in the region in terms of clinical, research and academic excellence.”

Read more on the Cedars-Sinai Blog: Taking the Fear Out of Colon Cancer Screening

Robert Figlin, MD, interim director of Cedars-Sinai Cancer and professor of Medicine and Biomedical Sciences at Cedars-Sinai, sat down with the Cedars-Sinai Newsroom to answer common questions about the disease and options for patients.

What does it mean to have stage 4 prostate cancer?

All cancers are diagnosed by stage. Stage 4 is when the disease has spread from the primary area or organ—in this case, the prostate gland—to other areas. The most common place that prostate cancer spreads is to the bone, although it can spread to other organs such as the lungs, lymph nodes or liver.

How is prostate cancer treated?

The standard of care for prostate cancer, by and large, when newly diagnosed, is to turn off the stimulation of the prostate cancer cell by blocking androgens, including testosterone, either where they are made or where they act with the cancer to cause cancer to grow. So, androgen suppression through treatments that reduce testosterone levels is the treatment of choice, primarily for hormone-sensitive prostate cancer. Having said that, recent evidence suggests that you can add chemotherapy to hormone treatment for men with prostate cancer that improves both their progression-free survival and their overall survival.

What is the expected prognosis for a patient with stage 4 prostate cancer?

Prostate cancer, when metastatic, whether it's aggressive or nonaggressive, is not currently a curable disease. So, what we can expect is that control of the cancer should be easily obtained using hormone ablation. This will certainly improve what's called progression-free survival, meaning that it'll slow the growth of the cancer to other areas, it will prolong survival, but it will not be curative.

What are the screening recommendations for prostate cancer?

The standard screening recommendation for men is a digital rectal examination and a PSA blood test on an annual basis. The PSA test measures a hormone called prostate-specific antigen, which may indicate prostate cancer when found at high levels. But currently, it's not recommended that men beyond the age of 70 have routine screenings, because in population studies, there's been no evidence that screening elderly men improves overall survival. Having said that, that should still be a discussion between the physician and the patient to see whether screening is appropriate.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

“Mary Ann and her husband told me that he had been working for 45 years, was retiring at the end of the year, and that they were planning this trip,” said breast surgical oncologist Ronald Hurst, MD. “I worked to quickly determine her tumor type, the treatment that she would need and whether it could be completed in time.”

Hurst, who saw Loef at Cedars-Sinai Marina del Rey Breast Health, first needed to find out whether the cancer was HER2 positive so he would know whether Loef would need to complete chemotherapy and immunotherapy before undergoing surgery to remove the tumor. Hurst also needed to determine whether the cancer had spread to her lymph nodes, and whether it was likely to recur, so he would know whether she would need to follow surgery with chemotherapy.

“If you don’t push things along, some of these steps can take weeks,” said Hurst, who also sees patients at The Angeles Clinic and Research Institute, an affiliate of Cedars-Sinai Cancer. “I became her advocate because I knew her trip was already planned, and I think we cut at least a month from the usual timeline. Everything aligned perfectly and we were able to complete surgery and determine her full course of treatment within two weeks.”

After finding the lump and having a mammogram at RadNet Westchester Advanced Imaging and a biopsy at RadNet Mink Radiology—both Cedars-Sinai affiliates—Loef was referred to Hurst by her primary provider.

It was September, and she and her husband had a January departure date set for the cruise. Hurst diagnosed an early-stage HER2-negative, estrogen-driven tumor that was localized to a small segment of her breast and had not spread. This meant she was a candidate for breast-conserving surgery and would not need chemotherapy or immunotherapy before or after the procedure.

“It was such a relief because I thought I was going to be in the hospital for a week,” she said. “But Dr. Hurst said I would be home by lunchtime. I had just a few stitches, and it was almost painless. Tylenol was the only pain medicine I needed.”

Hurst said many people diagnosed with breast cancer imagine they have a much more difficult road ahead.

“Most patients, when they hear a cancer diagnosis, automatically think of mastectomy and chemotherapy, with a lengthy recovery and side effects. And I have to tell them to take a deep breath, because that's not necessarily going to be their journey,” Hurst said. “If it is, we know how to help them through that, but let's not get ahead of ourselves.”

In fact, many patients with early-stage breast cancer are candidates for breast-conserving surgery, where the tumor and a perimeter of normal tissue are removed but the breast is preserved, Hurst said. And some types of cancers can be managed without chemotherapy.

“We treat breast cancer one patient at a time,” said Armando Giuliano, MD, director of the Division of Surgical Oncology at Cedars-Sinai. “There are many factors in addition to the medical diagnosis that need to be taken into account, including quality of life and peace of mind for the patient.”

Cedars-Sinai Marina del Rey Breast Health, a partnership between Cedars-Sinai, Breastlink and RadNet, offers a one-stop shop for screening, evaluation and diagnosis of breast cancer—under the care of Hurst and his colleague Marissa K. Boyle, MD, a surgical oncologist. The goal is to speed patients through the initial steps of imaging and biopsy, to get them more quickly into treatment.

With surgery behind her, Loef completed four weeks of radiotherapy before her departure. She saw Lauren Midthun, MD, a medical oncologist at The Angeles Clinic and Research Institute, who prescribed a hormone suppressor that Loef will take for five years to help prevent cancer recurrence.

During their four-month world cruise, she and her husband will visit Hawaii, Fiji, New Zealand, Australia, South Africa, Namibia, the Cape Verde Islands, Italy, Greece, Turkey, France, Spain, Corsica, Marseille, Montenegro, Malta, Morocco, the Canary Islands, Colombia, the Panama Canal, Costa Rica, Guatemala and Mexico.

“Our honeymoon was a cruise, and for 38 years, that's been our preferred method of vacationing,” Loef said. “During all that time, my husband has been so devoted to providing for our family, and this round-the-world trip has been our dream. The thought of not getting to go through with it really was weighing heavily on me, because he deserves this, and it will just be really, really, really something very special to share.”

Read more on the Cedars-Sinai Blog: What Does It Mean to Have Dense Breasts?

“The incidence of pancreatic cancer among the Black population is at least 50% higher than the incidence of other racial groups. Furthermore, research has shown that Black patients have the lowest survival rate,” said Debiao Li, PhD, director of the Biomedical Imaging Research Institute and professor of Biomedical Sciences and Imaging at Cedars-Sinai, and co-principal investigator of the study. “We know that there are genetic, socioeconomic and lifestyle differences between ethnic and racial populations, and we suspect some of these differences might affect pancreatic tissue and pancreatic cancer risk.”

Li and co-investigators received a grant from the National Cancer Institute in 2022 and developed a tool that uses CT scans and AI to detect minute changes in the pancreas, which is part of the digestive system. These changes can indicate a patient is likely to develop pancreatic cancer years before they develop the disease, thus enabling an earlier diagnosis when treatments are most effective. This investigative team has received a new grant to conduct a pilot study that will allow them to determine whether those characteristics differ in Black patients.

The team will collaborate with Cemal Yazici, MD, associate professor of Medicine at the University of Illinois Chicago, which, like Cedars-Sinai, serves a large population of Black patients.

Predictive models for pancreatic cancer based on symptoms, genetics and weight haven’t been shown to be accurate on their own, said Stephen Pandol, MD, director of Basic and Translational Pancreas Research at Cedars-Sinai and co-principal investigator of the study. Meanwhile, blood and urine tests for pancreas cancer are still in development.

“Packaging these tests with our imaging tool could eventually prove effective in predicting who will develop pancreatic cancer,” Pandol said. “Our goal is to perfect our tool, then apply it to a population to see if we can diagnose individuals earlier.”

Pancreatic cancer is one of the deadliest cancers, with only around 10% of patients surviving five years after diagnosis. Early detection and surgical intervention can increase five-year survival rates to more than 50%, but this is rare because early pancreatic cancer causes few symptoms.

“Drilling down to understand cancer risk at precision levels is key to the Cedars-Sinai Cancer mission to bring personalized cancer care to every patient,” said Dan Theodorescu, MD, PhD, director of Cedars-Sinai Cancer and the PHASE ONE Foundation Distinguished Chair. "This work in early detection nicely complements recent work showing that a new AI-based precision medicine approach called the Molecular Twin Precision Oncology Platform can predict outcomes of pancreatic cancer."

With the help of improved predictive tools, patients at the highest risk can be monitored via annual imaging so any cancer that develops is detected at the earliest stage.

“If we can diagnose a patient’s pancreatic cancer two or three years earlier, that could make a life-and-death difference,” Li said.

Read more on the Cedars-Sinai Blog: Pancreatic Cancer Clinic Saves Time and Lives

In this study, investigators looked at data from more than 48,000 patients in the National Cancer Database. Based on preoperative imaging, all of the patients in the study had either stage 1 or stage 2 pancreatic cancer.

Following surgery to remove their tumors, more than 78% of stage 1 patients and more than 29% of stage 2 patients were upstaged—generally to a stage that includes lymph node involvement.

“Our research reveals that staging—essential for making treatment decisions and determining research eligibility—is often inaccurate in early-stage pancreatic cancer,” said Srinivas Gaddam, MD, associate director of Pancreatic Biliary Research at Cedars-Sinai and senior author of the study. “As the field is racing toward earlier diagnosis, early staging will become increasingly important.”

Diagnosis and staging of pancreatic cancer are difficult for the same reason. The pancreas, a digestive organ, is located deep in the body and current imaging technology isn’t always able to detect smaller tumors or lymph node involvement, said Gaddam, who is also an associate professor of Medicine and runs the Pancreatic Cancer Screening and Early Detection Program at Cedars-Sinai.

Lymph nodes, clusters of small immune structures, are an important factor in cancer staging and a key difference between early-stage and later-stage pancreatic cancer.

“Patients who have lymph node involvement have a worse survival rate than those without lymph node involvement,” Gaddam said. “When imaging is unable to detect lymph node involvement, staging may not reflect the true extent of the disease. Our findings suggest that lymph node involvement is being missed in four out of every five patients during the staging process.”

The five-year survival rate for stage 1 pancreatic cancer is more than 83%, but that drops to just 3% for patients with stage 4 disease—which is when most patients are currently diagnosed.

“Pancreatic cancer is a difficult diagnosis and there is a tremendous need to improve outcomes for patients,” said Dan Theodorescu, MD, PhD, director of Cedars-Sinai Cancer and the PHASE ONE Foundation Distinguished Chair. “Through leading-edge tools, such as our Molecular Twin Precision Oncology Platform, we are developing tests that will guide precision treatment of pancreatic and other cancers. We first demonstrated the utility of Molecular Twin by identifying new biomarkers for pancreatic cancer; these biomarkers assist in the diagnosis, which must be coupled with accurate cancer staging to appropriately guide therapeutics.”

Gaddam’s take-home message for clinicians staging pancreatic cancer is to recognize the limitations of current imaging technology and actively assess and report lymph node involvement. And for those at the forefront of innovation, he stresses the urgent need to improve screening and diagnostic technologies.

Pancreatic cancer screening employs MRI and endoscopic ultrasound. Screening is recommended for people with a family history of pancreatic cancer and those who carry variants in certain genes associated with the disease.

“We know that our current screening and staging tools aren’t great,” Gaddam said. “My hope is that within the next 10 years, we will develop advanced tools for screening and staging pancreatic cancer, allowing us to diagnose most patients at stage 1 and stage 2 rather than stage 4. With these advancements, we can catch this disease much earlier, improving outcomes for many more patients.”

Additional Cedars-Sinai authors of the study: Gerardo Perrotta, MD; Ghada Mohamed, MD; Brent K. Larson, DO; Arsen Osipov, MD; Cristina R. Ferrone, MD; Simon K. Lo, MD.

Funding: Srinivas Gaddam received funding from the AGA (American Gastroenterological Association) Research Foundation’s 2022 AGA-Bern Schwartz Family Fund Research Scholar Award in Pancreatic Cancer for time dedicated to research.

Learn more on the Cedars-Sinai Blog: Pancreatic Cancer Clinic Saves Time and Lives