Abstract IA-004: Using an integrative molecular epidemiology approach to battle pancreatic cancer in the era of precision medicine: Hope is on the horizon
Authors: Permuth Jennifer B 
Published: November 2021

Abstract
Pancreatic cancer is the most lethal solid malignancy in the United States, with a 5-year relative survival rate of only 10.8%. Novel strategies are needed to prevent disease and/or detect it as early as possible. There is also an urgent need to study and address biological reasons for the higher pancreatic cancer incidence and mortality rates among African Americans compared to other racial and ethnic groups. Integrative molecular epidemiology is a discipline that brings together epidemiologists, data scientists, basic scientists, and many clinical specialties, to collaboratively study cancer risk and outcomes from different perspectives. This lecture will provide examples of how an integrative molecular epidemiology approach has been used to advance pancreatic cancer early detection and health disparities initiatives. Pancreatic cancer precursor lesions known as intraductal papillary mucinous neoplasms (IPMNs) are cystic lesions increasingly being detected incidentally by imaging, but strategies are lacking to accurately differentiate ‘low risk’ lesions that should be monitored from ‘high-risk’ lesions that should be surgically removed. By leveraging expertise in population, clinical, and data science and informatics and multi-institutional infrastructure known as the Florida Pancreas Collaborative, the investigative team is evaluating the hypothesis that unexplored categories of quantitative ‘radiomic’ features extracted from preoperative computed tomography scans will improve the diagnostic value in predicting malignant IPMN pathology. They further hypothesize that a liquid biopsy that measures microRNAs circulating in blood plasma (a miRNA genomic classifier (MGC)) that they have developed may further enhance diagnostic accuracy. The team ultimately plans to generate prototype clinical decision-making models, or nomograms, that consider radiomic data, the MGC, and other clinical characteristics to aid in predicting IPMN pathology. To improve outcomes and minimize disparities for the diverse population of Floridians affected by pancreatic cancer, the Florida Pancreas Collaborative has also been prospectively building a robust ‘next-generation biobank’ that longitudinally collects blood, various tissue types, medical images, and clinical, laboratory, epidemiologic, and outcome data. They are also testing the novel hypothesis that biological correlates of cancer cachexia contribute to observed pancreatic cancer disparities. Through these initiatives and an integrative molecular epidemiology approach, the team’s long-term goal is to improve survival and quality of life and minimize disparities by personalizing care for individuals with or at risk for pancreatic cancer.
Citation Format: Jennifer B Permuth. Using an integrative molecular epidemiology approach to battle pancreatic cancer in the era of precision medicine: Hope is on the horizon [abstract]. In: Proceedings of the AACR Virtual Special Conference on Pancreatic Cancer; 2021 Sep 29-30. Philadelphia (PA): AACR; Cancer Res 2021;81(22 Suppl):Abstract nr IA-004.