On Sunday, September 2, at the Castle of Paderna, near Piacenza, the event “Start Sowing for Life” took place, organized in memory of Angelo Medaglia, a veterinarian from Pontenura who recently passed away. An event wanted by the community of Angelo Medaglia, which brought together the friends of the doctor and the owners of his patient animals in a day of celebration.

In the afternoon, an exhibition of martial art Qwan Ki Do and the amateur parade of “four-legged friends” was held, followed by a charity dinner with chefs from the Academy of Piacenza cuisine attended by more than 400 people. The event was also attended by Professor Alessandro Zerbi, Head of Pancreatic Surgery of Humanitas, and some colleagues: the funds raised will be donated to the Humanitas Foundation for Research and in particular in favor of activities for the study and treatment of pancreatic cancer, conducted by the Operative Unit of Pancreatic Surgery.

What research projects is the Pancreatic Surgery team involved in? We talk about it with Professor Alessandro Zerbi.


The importance of research in pancreatic cancer

“Research in the field of pancreatic cancer is fundamental. It is estimated that in 10-15 years it will be the second most common cause of death from cancer in Western countries. The pancreatic cancer is in fact a malignant tumor, strongly aggressive, unfortunately characterized by a high mortality rate. This has also been mentioned recently, following the death of Aretha Franklin, who has suffered from pancreatic cancer. However, few resources are allocated to research in this field and initiatives such as the one on Sunday are valuable, in order to support researchers in an attempt to make more and more progress in dealing with this type of cancer.

As an Operative Unit of Pancreatic Surgery, we are involved in various research projects and have published numerous studies, in collaboration with other research groups and other Operative Units of Humanitas. In particular, we work in two areas: basic research, i.e. laboratory research, in collaboration with basic researchers, and research in the clinical-surgical field,” says Professor Zerbi.


Basic research

“As far as basic research is concerned, we work with researchers not only by providing them with biological materials and clinical information about the patients involved in the studies, but above all by discussing the aspects of the research to be deepened or investigated together,” says the professor.


Pancreatic tumors and the immune system

“One of the major fronts of basic research on which we are engaged concerns the interactions between pancreatic cancer and the immune system, in collaboration with the research group led by Professor Alberto Mantovani and in particular with Dr. Paola Allavena and Federica Marchesi. The aim of the studies is to try to understand the relationship between pancreatic cancer and the immune system, in order to discover how the latter is an effective ally in fighting cancer and how much it plays against the body.

We are also working to find biomarkers that can help us in the early detection of pancreatic cancer and predict its prognosis. We are also studying the role of pancreatic juice, which is taken during surgery and provided to researchers, in an attempt to characterize the tumor, its metabolism and immune response, with the hope of better defining the behavior of this tumor.

In collaboration with the group of Professor Gioacchino Natoli, we are then engaged in trying to characterize the different cell types of pancreatic cancer, in order to subclassify the tumor into molecular types. This approach is also applied to other types of tumors and it is thought that in the future it could open the way to personalized therapy even more: in fact, different cell types could respond differently to different treatments.

With the group of Dr. Luigi Laghi we are engaged in identifying specific markers of development and prognosis of pancreatic cancer, while with the group of Professor Andrea Lania we deal with endocrine tumors of the pancreas (pancreatic tumors that are less aggressive than pancreatic cancer), with the aim of investigating the cellular mechanisms of response of these tumors to therapies (especially hormonal) intended to slow their growth, in order to better characterize the behavior of cells of endocrine pancreatic tumors”, explains Professor Zerbi.


Research in the clinical-surgical field

“As for research in the clinical-surgical field, however, we are working on several projects. One concerns the very topical issue of surgical infections, which is of increasing importance in all surgeries. Many of the patients with pancreatic cancer who have to undergo surgery have jaundice. Before surgery, therefore, they undergo an endoscopic procedure that, by applying stents, aims to resolve the jaundice. However, this procedure can cause an infection of the bile, a serious problem because the germs are often multi-resistant and therefore it is not easy to eradicate them. This can lead to complications during surgery, worsening the course of surgery. We are therefore working on several fronts to try to solve this problem (from bacteria, to endoscopic procedures, to stents used), in collaboration with the research groups of Professor Roberto Rusconi and Dr. Clelia Peano.

We also have collaboration with the Politecnico di Milano to develop new materials, instruments and devices designed specifically for pancreatic surgery. In fact, due to the lower volumes of intervention compared to other surgeries, pancreatic surgery has never been the starting point of technological evolution, but has always seen on itself the innovations developed for other surgeries. The challenge with the researchers of the Polytechnic is instead to start with pancreatic surgery and we hope that this project will bring benefits to patients in the future.

We also have ongoing studies with Humanitas diabetologists to try to predict the risk of diabetes in patients undergoing pancreatic surgery. We are working to apply the ERAS protocol (“Enhanced Recovery After Surgery”) to pancreatic surgery and in particular to prepare the patient of the respiratory terms at the surgery, in order to improve post-operative recovery. With the anesthetists of Humanitas we are instead thinking about the optimization of the infusion during the surgery, with the aim of identifying the best amount of liquids to be administered to the patient during the operation. We are also involved in important European multi-center studies dedicated to pancreatic resection surgical techniques, in particular with a minimally invasive approach”, continued the specialist.


The screening study for high-risk subjects

Finally, Humanitas is active in a screening study for pancreatic cancer dedicated to high-risk individuals: these are individuals who have an increased risk of developing this neoplasm due to the presence of strong family history or genetic predisposition.

These patients are included in a monitoring project aimed at enabling early diagnosis. This is a prospective surveillance study of subjects with probable genetic risk, who are followed by a series of investigations and possible diagnostic insights.