Dr Ecker on the Investigation of the Microbiome in Pancreatic Cancer

Brett L. Ecker, MD, surgical oncologist, member of RWJBarnabas Health Medical Group, Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, discusses the evaluation of the microbiome in pancreatic cancer, highlighting remaining questions and future steps for research.

At the Rutgers Cancer Institute of New Jersey's Annual Oncology Clinical Practice and Research Summit, Ecker presented foundational data supporting his ongoing pilot study on the pancreas microbiome. This research investigated how microbes within pancreas cysts might play a role in propelling dysplastic progression along the continuum, spanning from low-grade to high-grade dysplasia and eventually invasive cysts, he begins. The goal of this research is to discern, through the interplay between microbes and the epithelial, stromal, and immune compartments, potential targets to impede this progression, Ecker states.

Recent evidence has challenged the traditional notion of the pancreas is a sterile organ, revealing that, particularly in cancer contexts, microbes are often present, typically identified within tumoral cells, he expands. The association of these microbes with altered gene expression linked to metastatic spread and tumor growth prompts the question: are these microbes present in precursor lesions for pancreas cancer? Further questions focus on determining their presence, quantifying them across the dysplastic continuum, identifying species, and assessing microbial diversity, Ecker emphasizes. Moreover, further research should identify how these microbes affect cellular processes. This area of microbial research is relatively nascent, with advancements in technology over the past few years facilitating exploration, he notes.

In collaboration with the Karolinska Institute, Ecker has identified certain onco-bacteria, typically part of the oral microbiota, associated with high-grade dysplasia compared with low-grade dysplasia. To date, Ecker and his group are among the few to publish on this aspect, and anticipate contributing further to the burgeoning field of microbial research in the context of pancreas cancer.