A Q&A with Dr. George Zogopoulos about PRECEDE’s global clinical conference and its role in pancreatic cancer surveillance and early detection
Pancreatic cancer research is often discussed in terms of datasets, biomarkers and breakthroughs that may improve care in the future. Within the PRECEDE Consortium, investigators are also doing something different. They are bringing expertise from institutions around the world into conversations about the complex decisions clinicians face while caring for people undergoing pancreatic cancer surveillance.
For more than five years, Dr. George Zogopoulos, a surgeon-scientist at McGill University and the McGill University Health Centre in Montreal, has helped lead a monthly multidisciplinary clinical conference that brings together 30 to 45 PRECEDE investigators and clinicians.
We spoke with Dr. Zogopoulos about the conference, the challenges of pancreatic cancer surveillance and how PRECEDE is creating a two-way exchange between research and patient care.
What is the PRECEDE clinical conference?
The PRECEDE clinical conference is a monthly multidisciplinary discussion involving clinicians and investigators who care for people at elevated risk for pancreatic cancer.
Surgeons, gastroenterologists, oncologists, geneticists, genetic counselors and other specialists review complex cases, discuss imaging findings and compare how different institutions approach surveillance. The conference gives us an opportunity to learn from one another and better understand the day-to-day real-world experiences of pancreatic cancer surveillance in different healthcare systems across PRECEDE’s international network.
Why did PRECEDE establish the conference?
PRECEDE was created to improve pancreatic cancer early detection and survival by bringing together researchers, clinicians, trainees, and people at increased risk of developing pancreatic cancer to build a community focused on improving outcomes.
Collecting and analyzing research data are essential parts of that mission, but from the outset, we also wanted PRECEDE to create opportunities for clinicians to learn from what they are seeing in practice. This conference helps connect PRECEDE’s research mission with the difficult and often immediate questions clinicians encounter in caring for patients and families today.
What types of cases are discussed?
We often discuss cases involving an unexpected or uncertain finding on a surveillance examination. For example, an MRI or endoscopic ultrasound may identify a pancreatic cyst or another abnormality without providing a definitive answer about what it represents or how to treat the abnormality.
Participants may discuss whether a patient should undergo additional testing, continue to be monitored, or be considered for surgery. We also review cases in which patients received treatment so the group can learn from what was discovered.
Why is pancreatic cancer surveillance so challenging?
Pancreatic cancer surveillance is an evolving area of medicine. Although recommendations exist for monitoring people at elevated risk, unanswered questions remain about how surveillance should be conducted and how certain findings should be managed.
Not every pancreatic abnormality will develop into cancer, and unnecessary procedures can create risks. Clinicians must carefully determine when to monitor a finding, order additional testing or consider an intervention.
Guidelines cannot anticipate every clinical scenario. Discussing difficult cases with specialists from different disciplines and institutions from around the world can add valuable perspective.
Does the conference make treatment decisions for patients?
No. The treating physicians and medical institutions remain responsible for each patient’s care.
The conference does not replace the expertise of individual PRECEDE sites. It adds a cross-institutional layer of perspective by allowing participants to hear how colleagues have approached similar situations and consider whether those experiences are relevant to the case being discussed.
You describe the conference as a “community of practice.” What does that mean?
A community of practice is a group of professionals who regularly come together to share knowledge, discuss challenges and learn from one another. That is what we are building through the clinical conference. We are not only exchanging research findings. We are also discussing how pancreatic cancer surveillance is being delivered and what members are learning from the patients they care for.
The conference creates a consistent space for collaboration across specialties, medical centers and countries. It also creates an important training environment for the next generation of clinicians and researchers, while helping to expand expertise in pancreatic cancer surveillance globally.
How does the conference connect research and patient care?
The conference helps create a two-way exchange between research and patient care. Insights from patients and clinical practice can help investigators identify patterns, unanswered questions and areas requiring further study. At the same time, knowledge from PRECEDE’s international network can help clinicians think through surveillance challenges they are encountering today. Research informs clinical practice, while clinical experience helps shape future research.
How is PRECEDE helping to evolve the way pancreatic cancer is researched and treated?
PRECEDE brings together an international network of researchers and clinicians to collect and analyze data aimed at improving pancreatic cancer surveillance and early detection. Through the clinical conference, members also share what they are learning in practice and consider how those insights might inform future research, surveillance protocols and clinical approaches. It is a connected model in which research and patient care inform one another rather than operating on separate tracks.
Why does early detection remain important as new treatments emerge?
New treatments, including therapies that target KRAS mutations, represent important progress. However, many are intended for people whose cancer has already reached a more advanced stage.
Pancreatic cancer is most likely to be treated successfully when it is found before it has spread and while surgery remains possible. We need progress on multiple fronts. Researchers must develop better treatments while also improving our ability to detect pancreatic cancer at its earliest and most treatable stages.
Why does PRECEDE focus on people at elevated risk?
Screening the entire population for pancreatic cancer is not currently practical. Tests used for surveillance, including MRI and endoscopic ultrasound, can be burdensome and are not appropriate for everyone.
People with a strong family history of pancreatic cancer or certain inherited genetic mutations provide an important starting point. By studying and monitoring this population, researchers can learn more about how the disease develops and search for its earliest signs.
Those findings may also support the development of less invasive early-detection tools that could eventually benefit a broader population.
What makes PRECEDE more than a research entity?
PRECEDE has built one of the world’s largest cohorts of people at elevated risk for pancreatic cancer, but it is also building an international community committed to learning from one another. The clinical conference reflects that broader mission. PRECEDE members come together not only to discuss data, but also to consider the patients, clinical questions and real-world challenges behind it. The consortium is advancing future discoveries while
supporting collaboration among the clinicians caring for high-risk patients today.
What do you hope the conference will accomplish in the future?
I hope it continues to strengthen connections among PRECEDE clinicians and investigators and helps us refine how we approach pancreatic cancer surveillance. We still need to learn which findings present the greatest risk, how often people should be monitored and how imaging, biomarkers and other technologies can support earlier detection. Most importantly, we want to keep the patient at the center of the discussion and use what we learn to advance both pancreatic cancer research and care.
About
Dr. George Zogopoulos is a Professor of Surgery and Oncology at McGill University and a hepato-pancreato-biliary and transplant surgeon at the McGill University Health Centre. He is also a scientist at the Research Institute of the McGill University Health Centre and the Rosalind and Morris Goodman Cancer Institute.
His research focuses on the genetics and oncogenomics of pancreaticobiliary cancers. He helps lead PRECEDE’s monthly multidisciplinary
clinical conference, which brings together clinicians and investigators from across its international network.
