A NEW IMAGE: INDENTIFYING CANCER CELLS

Clinical PGY3 Surgical Resident Dr Isabel Dennahy was awarded the Association for Academic Surgery /AASF Trainee Basic Science Translational Research Award and a $30,000 grant for her proposal "Novel Imaging Techniques in the Diagnosis and Treatment of Pancreatic Cancer.”

“What we’re going to be working on is developing a florescent targeted dye specifically for pancreas cancer cells, with the idea that it can be used intraoperatively to detect areas where the cancer is still present to guide resection,” Dr. Dennahy said. The surgeon explained she was inspired to pursue her proposal based on her passion for pancreatic cancer treatment and Vice Chair of Academic and Research Advancement Dr Lacey McNally’s similar studies in breast cancer

“You attach a fluorescent dye to a specific protein that will target the cancer cell,” she said “First, we need to make the protein ” Dr Dennahy will conduct her research in Dr McNally’s lab. “In her lab, there is a peptide synthesizer. You input all of the amino acids in the correct proportions to make the protein and then it synthesizes it and then you go through several steps to process it and clean it up,” she said.

Dr Dennahy explained that once the protein is created she will attach a CW-800 fluorescent peptide-based target dye to create the imaging technology

Following that process, Dr Dennahy and Dr McNally will begin a testing series to ensure the target marker accurately targets cancer cells in the pancreas.

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“First, we are going to test it on a pancreas cancer cell line. Then, we will test it in cell lines from other organs to confirm that it binds to the pancreas and not as much in other organs so we’ll know it’ll have a good signal in one area and not the whole body,” she said.

Next, Dr Dennahy will test different lengths of the protein to see which one has the strongest signal The resident will then select the best protein and test it in cultured pancreas cancer cells from actual patient tumors and make sure that it binds well in an actual patient tumor as well as cell lines

“No one tumor is the same, and there are often differences even within the same tumor So, this will be the next step to show our protein withstands those differences,” she said. After the cell testing, Dr. Dennahy explained she will begin the next phase of testing her markers. “We’re going to be testing the markers in mice and we’re going to be doing that using a model where you inject the sample of the tumor into the mouse’s pancreas and it develops there. Then we’re going to give the mouse the marker,” she stated.

According to Dr Dennahy, things work really well in cells, but when put in the body there are many other factors to consider including the distribution, the blood supply, etcetera Should the dye become a successful marker for pancreas cancer, Dr Dennahy explained it could be used with various forms of imaging existing technical systems such as the Da Vinci Surgical Systems

“The Da Vinci Surgical Systems have the Firefly Feature which we currently use in gallbladder cases with a different kind of dye,” she said. “The dye that we’re developing now will be usable with the same technology.

Additionally, Dr Dennahy’s marker will be compatible with multi-spectral optoacoustic technology (MSOT) The resident explained that the purpose of this study is to prevent unnecessary operations or guide surgical resection to provide better care for pancreatic cancer patients “If we’re successful with what we’re doing, eventually this could be used preoperatively to get a much better idea as to whether these patients are operative candidates,” she said.

Dr. Dennahy feels pancreatic cancer research is an area with some of the most potential for growth and positive results in advancing treatments. She explained how imaging now can’t accurately differentiate between treated cancer and live cancer after patients have had chemotherapy

“That really affects whether or not those people should get an operation, or the kind of operation that would best for them,” she said The resident explained for those who need an operation this technology would help the surgeons limit how radical their resection is Dr Dennahy is especially grateful to her mentors.

“I think when I have someone as supportive as Dr. Ajay ”