The Relationship Between Brain Metastases and Pancreatic Cancer
Introduction: Pancreatic cancer, most commonly pancreatic ductal adenocarcinoma (PDAC), is the third most lethal form of cancer in the United States. It is difficult to diagnose due to its location and the commonality of the symptoms and is most often found at an advanced stage, making its 5-year survival rate one of the lowest. Therefore, most patients are diagnosed at a later stage once metastases have already developed. This increases the chances of metastasis to other organs, including the brain, due to the cancer cells’ ability to exist in latency for prolonged periods of time. Brain metastases present a major challenge for future oncological research, as they are difficult to treat. If we can identify the pancreatic cancer patients and areas within the body most associated with brain metastases, we can monitor those areas for rapid therapeutic intervention. There is limited research and understanding of the relationship between brain metastases and pancreatic cancer.
Methods: Adults who had been diagnosed with metastatic pancreatic cancer were the eligibility criteria. We performed a retrospective, non-interventional study so there were no treatment risks to the patients involved. Once the protocol was approved, it was provided to the collaborating institutions. They wrote a data collection algorithm to gather data from their electronic health records and analyzed to look for patterns in the patients’ information. The primary objective was to determine the temporal or spatial relationships between pancreatic cancer and brain metastases. The secondary objective was to discern potential metastatic similarities between patients with pancreatic cancer by assessing how long the patient has pancreatic cancer, Tx Hx, age, etc. All of the patients analyzed were seen at Honor Health.
Results: This clinical trial was initiated in May 2019. 1322 patients were identified with metastatic pancreatic cancer, 38 (2.87%) of which had the cancer metastasize to the brain. The sample set is taken from the past 11 years of electronic health records at Honor Health.
Conclusion: This is the largest study of pancreatic cancer patients with brain metastases that we could find. 38 patients out of 1322 had brain metastases compared to the most recent and comprehensive review we could find which had 21 cases. This trial will continue with the inclusion of patients from the participating institutions other than Honor Health . Further analyses will be done to determine possible correlations between other metastatic locations and brain metastases, and to calculate the time in between the initial pancreatic cancer diagnosis and detection of the brain metastasis.