Patient Resiliency and Cachexia Biology

Pancreatic diseases inflict a huge burden of suffering on patients, dramatically impacting their quality of life. Patients with pancreatitis frequently have severe pain that requires prolonged hospital stays and significantly limits their activities once discharged; after recovery, many suffer from malnutrition. In patients with pancreatic cancer, even small pancreatic tumors will induce cachexia, a major barrier during treatment in addition to quality of life.

The Brenden-Colson Center for Pancreatic Care is dedicated to improving patient resiliency and quality of life through supporting research critical for understanding drivers of cachexia, malnutrition, and other debilitating symptoms. We are discovering novel treatment options and anticipate that increasing resiliency will decrease the length of post-surgical hospital stays and increase survival time.

Ongoing Research Projects

While the exact mechanisms linking pancreatic cancer to cachexia are unknown, our physicians and researchers are working to identify anti-cachexia agents and blood-based biomarkers. The ultimate goal is to integrate these discoveries into our Pre-habilitation program, which is designed to help patients become as healthy as possible before surgery or chemotherapy through nutritional, pharmaceutical, and behavioral therapy.

  • Some of our current research focuses on understanding the role of pancreatic cancer extracellular vesicles (submicron-sized particles secreted by cells) in neuroinflammation and visceral pain.
  • We are also investigating how metabolic reprogramming and undernutrition impact pancreatic cancer cachexia.

Dr. Aaron Grossberg is leading an effort to incorporate cachexia metrics into the Pancreas Translational Tumor Board and our clinical workflow. His lab is optimizing a method to quantify muscle wasting by analyzing pre-surgical CT images. Implementing this metric would provide vital prognostic information to clinicians and could be used to better understand patient outcomes.

The following projects represent our commitment to a multifaceted approach to pancreatic cancer and cachexia research. 

  • Muscle biomarkers of cachexia, surgical and oncologic outcomes in pancreatic cancer – Aaron Grossberg
  • Evaluating the role of neoadjuvant therapy on pancreatic cancer resection outcomes – Aaron Grossberg
  • How metabolic reprogramming in the liver impacts tissue wasting, physiology, and survival in pancreatic cancer – Aaron Grossberg
  • Sarcopenia analysis in pancreatic cancer – Stephanie Krasnow
  • ACTO: A Phase 2, Pilot Randomized Trial of Olanzapine in the Treatment of Cancer Cachexia  – Eric Roeland
  • RIVER PDAC: A Phase 2b/3, Randomized, Double-Blind Study to Investigate the Efficacy, Safety, and Tolerability of Ponsegromab (PF-06946860) Compared with Placebo, Both with Background First-Line Chemotherapy in Adult Participants with Cachexia and Metastatic Pancreatic Ductal Adenocarcinoma – Eric Roeland
  • Understanding the role of Myc in pancreatic cancer cachexia – Rosalie Sears
  • Using tissue microarrays from patient samples to study pancreatitis – Rosalie Sears
  • Developing and characterizing new models of pancreatic cancer cachexia – Teresa Zimmers
  • Investigating the role of OSM-OSMR in the pancreatic tumor microenvironment’s effect on cachexia – Teresa Zimmers

OHSU Specific Resources:

Cachexia Resources:

Exercise Resources:

Other Resources: