2025 Early Detection Grant - Dr William McGahan

Like bowel, breast, and skin cancer, pancreatic cancer starts as a small abnormal  growth called a precursor lesion. If found early, these lesions can be removed before  they turn into cancer. For other cancers, we have reliable ways to find these lesions  early - such as polyps during colonoscopy, changes seen on a mammogram, or a  suspicious mole on skin check. But for the majority of pancreatic cancer, the precursor  lesion is entirely invisible to current imaging techniques. This remains the single  greatest challenge in early detection for this disease. 

Our team has recently shown that a new type of PET scan may detect precursor lesions  at the point just before becoming cancer. Lesions at this stage are called high-grade  dysplasia, and this is the best time to remove them. But there remains a major  challenge: even if a PET scan shows a suspicious area, the precursor lesion will still be  invisible to the naked eye during surgery. This means it is still impossible to accurately  biopsy the area in question, or remove only a small part of the pancreas containing the  precursor lesion.  

We propose a solution to this problem. Treatment of other cancers has benefited  recently from the use of fluorescence-guided surgery, where a glowing fluorescent dye  helps highlight cancer tissue under special light. We plan to attach this glowing dye to  the same molecule used in the PET scan. This could make high-grade precursor lesions  light up during surgery, helping surgeons find and remove them safely - without taking  out large parts of the pancreas. 

With this funding, we will create this new fluorescent molecule. We will first test  whether it makes high grade precursor lesions visible in pancreatic tissue that has already been removed from patients during surgery. We will then evaluate it in mice with  high grade precursor lesions or early pancreatic cancer. If successful, the next step will  be to trial the molecule in people at high risk of pancreatic cancer, ultimately moving us  closer to detecting and treating the disease at a pre-cancerous stage.