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Pancreatic Neoplasms: HELP
Articles by Bradley A. Hancock
Based on 3 articles published since 2010
(Why 3 articles?)
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Between 2010 and 2020, Brad A. Hancock wrote the following 3 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Clinical Trial Vascular endothelial growth factor, a novel and highly accurate pancreatic fluid biomarker for serous pancreatic cysts. 2014

Yip-Schneider, Michele T / Wu, Huangbing / Dumas, Ryan P / Hancock, Brad A / Agaram, Narasimhan / Radovich, Milan / Schmidt, C Max. ·Department of Surgery, Indiana University School of Medicine, Indianapolis, IN. Electronic address: maxschmi@iupui.edu. · Department of Surgery, Indiana University School of Medicine, Indianapolis, IN. · Department of Pathology, Indiana University School of Medicine, Indianapolis, IN. · Department of Surgery, Indiana University School of Medicine, Indianapolis, IN; Department of Biochemistry/Molecular Biology, Indiana University School of Medicine, Indianapolis, IN; Walther Oncology Center, Indiana University School of Medicine, Indianapolis, IN; Indiana University Cancer Center, Indianapolis, IN; Richard L Roudebush VA Medical Center, Indianapolis, IN. ·J Am Coll Surg · Pubmed #24491241.

ABSTRACT: BACKGROUND: Mucinous pancreatic cysts (intraductal papillary mucinous neoplasm and mucinous cystic neoplasm) have the potential to progress to invasive pancreatic adenocarcinoma, presenting an opportunity for early detection, prevention, and cure. Serous cystic neoplasms (SCN) have no malignant potential, but can mimic mucinous pancreatic cysts on imaging. Therefore, identification of biomarkers that can distinguish between cystic lesions is critically important. We hypothesize that vascular endothelial growth factor (VEGF)-A levels in pancreatic fluid correlate with pathologic diagnosis. STUDY DESIGN: Pancreatic cyst/duct fluid samples were prospectively collected from patients undergoing pancreatic resection and correlated with surgical pathology. VEGF levels were detected by ELISA. VEGF-A and VEGF receptor 2 expression in pancreatic tissue was localized by immunohistochemistry. Genetic alterations of the von Hippel-Lindau gene were determined by targeted next-generation sequencing. RESULTS: Eighty-seven patients met inclusion criteria for enrollment. Final pathologic diagnoses included pseudocyst (n = 9), SCN (n = 17), mucinous cystic neoplasm (n = 24), low/moderate grade intraductal papillary mucinous neoplasm (n = 16), high-grade/invasive intraductal papillary mucinous neoplasm (n = 10), and pancreatic ductal adenocarcinoma (n = 11). VEGF-A was significantly upregulated in SCN cyst fluid compared with all other diagnoses (p < 0.0001). With a cut-off of 8,500 pg/mL, VEGF-A has 100% sensitivity and 97% specificity as an SCN biomarker. VEGF-A and VEGF receptor 2 are overexpressed in SCN cyst tissue. VEGF-C was also significantly elevated in SCN cyst fluid (p < 0.0001). With a cut-off set at 200 pg/mL, VEGF-C identifies SCN with 100% sensitivity and 90% specificity. The presence of a von Hippel-Lindau mutation in SCN cyst tissue correlates with elevated cyst fluid VEGF levels. CONCLUSIONS: This is the first report of a cyst fluid protein biomarker that can positively identify SCN. The ability to distinguish SCN from premalignant/malignant pancreatic cysts can spare the cost and risk of surveillance and surgical intervention in select patients.

2 Article Germline and Somatic DNA Damage Repair Gene Mutations and Overall Survival in Metastatic Pancreatic Adenocarcinoma Patients Treated with FOLFIRINOX. 2018

Sehdev, Amikar / Gbolahan, Olumide / Hancock, Brad A / Stanley, Melissa / Shahda, Safi / Wan, Jun / Wu, Howard H / Radovich, Milan / O'Neil, Bert H. ·Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana. asehdev@iupui.edu. · Center for Health Services Research, Regenstrief Institute, Indianapolis, Indiana. · Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana. · Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana. · Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana. · Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana. · Department of Surgery, Division of General Surgery, Indiana University School of Medicine, Indianapolis, Indiana. ·Clin Cancer Res · Pubmed #30131383.

ABSTRACT: PURPOSE: Pancreatic ductal adenocarcinoma (PDAC) is a lethal cancer with lack of predictive biomarkers. We conducted a study to assess DNA damage repair (DDR) gene mutations as a predictive biomarker in PDAC patients treated with FOLFIRINOX. EXPERIMENTAL DESIGN: Indiana University Simon Cancer Center pancreatic cancer database was used to identify patients with metastatic PDAC, treated with FOLFIRINOX and had tissue available for DNA sequencing. Baseline demographic, clinical, and pathologic information was gathered. DNA isolation and targeted sequencing was performed using the Ion AmpliSeq protocol. Overall survival (OS) analysis was conducted using Kaplan-Meier, logistic regression and Cox proportional hazard methods. Multivariate models were adjusted for age, gender, margin status, CA 19-9, adjuvant chemotherapy, tumor and nodal stage. RESULTS: Overall, 36 patients were sequenced. DDR gene mutations were found in 12 patients. Mutations were seen in BRCA1 ( CONCLUSIONS: In a single institution, retrospective study, we found that the presence of DDR gene mutations are associated with improved OS in PDAC patients treated with FOLFIRINOX.

3 Article Pancreatic Cyst Fluid Vascular Endothelial Growth Factor A and Carcinoembryonic Antigen: A Highly Accurate Test for the Diagnosis of Serous Cystic Neoplasm. 2017

Carr, Rosalie A / Yip-Schneider, Michele T / Dolejs, Scott / Hancock, Bradley A / Wu, Huangbing / Radovich, Milan / Schmidt, C Max. ·Department of Surgery, Indiana University School of Medicine; Indiana University Health Pancreatic Cyst and Cancer Early Detection Center, Indianapolis, IN. · Department of Surgery, Indiana University School of Medicine; Department of Walther Oncology Center; Indiana University Cancer Center; Indiana University Health Pancreatic Cyst and Cancer Early Detection Center, Indianapolis, IN. · Department of Surgery, Indiana University School of Medicine. · Department of Surgery, Indiana University School of Medicine; Department of Walther Oncology Center; Indiana University Cancer Center. · Department of Surgery, Indiana University School of Medicine; Department of Biochemistry/Molecular Biology, Indiana University School of Medicine; Department of Walther Oncology Center; Indiana University Cancer Center; Indiana University Health Pancreatic Cyst and Cancer Early Detection Center, Indianapolis, IN. Electronic address: maxschmi@iupui.edu. ·J Am Coll Surg · Pubmed #28633941.

ABSTRACT: BACKGROUND: Accurate differentiation of pancreatic cystic lesions is important for pancreatic cancer early detection and prevention as well as avoidance of unnecessary surgical intervention. Serous cystic neoplasms (SCN) have no malignant potential, but may mimic premalignant mucinous cystic lesions: mucinous cystic neoplasm (MCN) and intraductal papillary mucinous neoplasm (IPMN). We recently identified vascular endothelial growth factor (VEGF)-A as a novel pancreatic fluid biomarker for SCN. We hypothesize that combining cyst fluid carcinoembryonic antigen (CEA) with VEGF-A will improve the diagnostic accuracy of VEGF-A. METHODS: Pancreatic cyst/duct fluid was collected from consenting patients undergoing surgical cyst resection with corresponding pathologic diagnoses. Pancreatic fluid VEGF-A and CEA levels were detected by ELISA. RESULTS: One hundred forty-nine patients with pancreatic cystic lesions met inclusion criteria. Pathologic diagnoses included pseudocyst (n=14), SCN (n=26), MCN (n=40), low/moderate grade IPMN (n=34), high grade IPMN (n=20), invasive IPMN (n=10) and solid pseudopapillary neoplasm (n=5). VEGF-A was significantly elevated in SCN cyst fluid compared to all other diagnoses (p<0.001). With a threshold of >5,000 pg/ml, VEGF-A alone has 100% sensitivity and 83.7% specificity to distinguish SCN from other cystic lesions. With a threshold of ≤10ng/ml, CEA alone identifies SCN with 95.5% sensitivity and 81.5% specificity. Sensitivity and specificity of the VEGF-A/CEA combination are 95.5% and 100% respectively. The c-statistic increased from 0.98 to 0.99 when CEA was added to VEGF-A alone in the ROC analysis. CONCLUSIONS: Although VEGF-A alone is a highly accurate test for SCN, the combination of VEGF-A with CEA approaches the gold-standard of pathologic diagnosis, thus importantly avoiding false positives. Patients with a positive test indicating benign SCN can be spared a high risk surgical pancreatic resection.