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Pancreatic CancerPAIR-PANCREASNCT04007640

Early Screening of Pancreatic Lesions : Development of New Imaging Tools

A study testing MRI with additional sequences, MRI and Left pancreatectomy or pancreaticoduodenectomy in people with Pancreatic Cancer, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Obesity, diabetes and metabolic syndrome (MS) have all been associated with increase of pancreatic cancer (PK) risk. The precise role of obesity and diabetes and the pathways involved in the early oncogenic phases of PK associated with MS are not well known. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Pancreatic Cancer
What is being tested?
MRI with additional sequences, MRI and Left pancreatectomy or pancreaticoduodenectomy
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
41 participants
Where
1 siteFrance
Study dates
18 Jun 2019to 31 May 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • 1st stage : Volunteers without history of known pancreatic disorders
  • Adults
  • 2nd stage : Obese Volunteers
  • Adults with planned hepatic MRI
  • Obese (BMI ≥30)
  • 3rd stage : Patients
  • Adults (aged 18-65 years) with a planned pancreatic surgery for benign pancreatic lesions (IPMN, cystic lesions or neuroendocrine tumors)
  • Obese (BMI≥30), overweight (25≤BMI≤29.9) or non-obese patients (18.5<BMI<24.9)

Who cannot join

  • For volunteers without history of known pancreatic disorders (1st stage):
  • Symptoms or past medical history suggesting pancreatic disorders
  • For all participants (1st, 2nd and 3rd stages) :
  • Patients with contraindication to MRI (pacemaker, claustrophobia…)
  • Inability to undergo MRI due to weight excess
  • Pregnant or breastfeeding woman
Show all 9Show fewer
  • Absence of free and informed consent
  • Non affiliation to a social security regime or CMU
  • Subject deprived of freedom, subject under a legal protective measure

Trial locations and contacts

1 site in 1 country.

France1 site
  • Hôpital Beaujon

    Clichy

Other trials in France

About this study

Official title: Early Stages of Pancreatic Cancer Associated With Obesity and Metabolic Syndrome: Prevention and Screening Tools - Imaging of Fatty Pancreas in Humans: Correlation With Pathological Analysis

Obesity, diabetes and metabolic syndrome (MS) have all been associated with increase of pancreatic cancer (PK) risk. The precise role of obesity and diabetes and the pathways involved in the early oncogenic phases of PK associated with MS are not well known. The investigators hypothesize that it is possible to decipher this specific "fat-fibrosis-neoplastic sequence", to develop new imaging tools adapted to follow its progression, to test the benefit of treatments to slow this sequence and prevent the development of PK in obese and diabetic patients.This project is in line with a prevention strategy, by planning to understand the physiopathological pathways involved in MS leading to PK, to develop tools useful to screen early precancerous lesions in order to diagnose and treat patients at high risk, before cancer involvement.

This clinical trial is part of the INCA PAIR PANCREAS project : Early stages of pancreatic cancer associated with obesity and metabolic syndrome:

prevention and screening tools - Imaging of fatty pancreas in humans: correlation with pathological analysis, which includes 3 main coordinated objectives an in vitro approach an in vivo approach and this study (clinical approach).

Read the detailed description

Translational approach with direct application to humans, to test specific imaging MRI sequences in obese patients.

Obesity and metabolic syndrome are a well-known risk factor of pancreatic cancer. Obesity is associated with about 30% increased risk in all studies, but the proportion of obese people varies considerably from one country to another. Therefore, the proportion of cancer attributable to obesity could range from 3% to 16%. Numerous epidemiological studies confirmed that obesity is a risk factor of pancreatic cancer in obese men and women (BMI, kg/m2≥30.0), with a relative risk estimated to 1.76 (95% CI, 0.90-3.45) and 1.70 (95% CI, 1.09-2.64), respectively. As previously demonstrated by partners 9 and 10, obesity is associated with fat pancreatic infiltration and precancerous lesions, such as PanIN lesions in humans. Pancreatic lesions such as adipose infiltration, iron deposits, extent of fibrosis, acino-ductal metaplasia and Pan-IN are involved in pancreatic oncogenesis.

The goal of this study is to be able to diagnose early precancerous states in patients, such as acino-ductal metaplasia (and also PanIN lesions which are more frequently observed in humans,) inflammatory process (iron deposits, fibrosis lesions) and adipose involvement in the context of obesity and metabolic syndrome. Investigators hypothesis is that specific MR imaging sequences, adapted from previous studies in rodents, could be a relevant tool to diagnose early pancreatic lesions and follow their evolution in the context of obesity and metabolic syndrome.

To this aim, the investigators will conduct a study to assess the relevance of MR imaging sequences to diagnose specific pancreatic lesions in obese patients, validated at the microscopic level. The investigators will analyze MR imaging of obese patients (BMI>30)/non obese patients (BMI<25) with a planned pancreatic surgery. It will be possible to compare imaging with histology performed on resected parenchyma. The investigators propose a proof-of-concept study aiming at assessing the relevance of specific MR imaging to diagnose early pancreatic lesions in humans and in obese patients especially. MR imaging will be performed in both obese and non obese patients with a planned pancreatic surgery in hospital to resect a benign lesion (such as neuroendocrine tumour or IPMN...). MRI are performed in the normal course of care; their sequences will be adapted for this study. It will be possible to compare imaging with histology of the resected parenchyma.

Being tested
MRI with additional sequences, MRI, Left pancreatectomy or pancreaticoduodenectomy
Keywords
Obesity, Diabetes, metabolic syndrome, Magnetic Resonance imaging,, Pancreatic Cancer, preneoplastic lesions, acino-ductal metaplasia,
Medical subject headings
Pancreatic Neoplasms, Obesity, Diabetes Mellitus, Metabolic Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • MRI with additional sequencesRadiation

    MRI with 15 min additional sequences to validate and assess pancreatic MRI sequences

  • MRIRadiation

    MRI with 15 min additional sequences to validate and assess pancreatic MRI sequences

  • Left pancreatectomy or pancreaticoduodenectomyProcedure or surgery

    Histological analysis :

  • MRI with additional sequencesRadiation

    MRI with 15 min additional sequences to assess the relevance of MRI to diagnose specific pancreatic lesions in obese patients

Study groups in NCT04007640
Study groupRoleWhat they receive
Volunteer patientOther1st stage: To adjust the transducer, test and validate pancreatic MRI sequences on volunteers without history of known pancreatic disorders. Adjustment of MRI parameters is needed to optimize data acquisition, especially in obese patients. Moreover, an external material (transducer) has to be applied on the abdomen. The right position has to be tested and specified before stages 2 and 3 of the study. We aim to include volunteers without history of known pancreatic disorders for the Stage 1, meaning volunteers without personal history or symptoms suggesting pancreatic disorders.
Receives: Radiation: MRI
Obese volunteers with indication for hepatic MRIOther2nd stage: To validate and assess pancreatic MRI sequences on obese volunteers with indication for hepatic MRI , in relation with acceptable resolution and field of view criteria applicable to the typical anteroposterior diameters found in obese persons. For Magnetic Resonance Elastography (MRE), the amplitude setting of the MRE transducer will be adapted to the size of obese patients, in addition to the aforementioned adjustments to spatial resolution and field of view sizes. The effect of frequency on MRE data quality will be investigated. The effects of respiratory motion will be investigated; indeed in obese patients respiration amplitude is typically low and this enables to acquire data in free breathing mode over long periods of time, which offers more possibilities (notably in terms of averaging, spatial resolution, mechanical wave sampling rate) than when constraining acquisition parameters with a maximum breath hold time of less than 20s.
Receives: Radiation: MRI with additional sequences
Obese patientOther3rd stage: To assess the relevance of MRI to diagnose specific pancreatic lesions in obese patients validated at the microscopic level. We will analyze MRI of obese patients and non-obese patients with a planned pancreatic surgery. It will be possible to compare imaging with histology performed on resected parenchyma
Receives: Procedure: Left pancreatectomy or pancreaticoduodenectomy; Radiation: MRI with additional sequences
Non obese patientsOther3rd stage: To assess the relevance of MRI to diagnose specific pancreatic lesions in obese patients validated at the microscopic level. We will analyze MRI of obese patients and non-obese patients with a planned pancreatic surgery. It will be possible to compare imaging with histology performed on resected parenchyma
Receives: Procedure: Left pancreatectomy or pancreaticoduodenectomy; Radiation: MRI with additional sequences
Overweight patientsOther3rd stage: To assess the relevance of MRI to diagnose specific pancreatic lesions in obese patients validated at the microscopic level. We will analyze MRI of obese patients and non-obese patients with a planned pancreatic surgery. It will be possible to compare imaging with histology performed on resected parenchyma
Receives: Procedure: Left pancreatectomy or pancreaticoduodenectomy; Radiation: MRI with additional sequences

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Quantitative MRI parameters

    Pancreatic fat content

    Measured: Day 1

  2. Quantitative MRI parameters

    Diffusion coefficients (10-4 mm2/s)

    Measured: Day 1

  3. Quantitative MRI parameters

    transverse magnetization relaxation rate

    Measured: Day 1

  4. Quantitative MRI parameters

    longitudinal relaxation rate

    Measured: Day 1

  5. Quantitative MRI parameters

    visco-elastic parameters by measure of tissue stiffness (kPa)

    Measured: Day 1

  6. fibroinflammatory lesions at histology in obese patients

    % surface of fibrosis

    Measured: 2 months

  7. fibroinflammatory lesions at histology in obese patients

    % surface of acinoductal metaplasia

    Measured: 2 months

  8. fibroinflammatory lesions at histology in obese patients

    number of acinoductal metaplasia lesions

    Measured: 2 months

Secondary outcomes (14)
  1. Histologic parameters

    % surface of fat pancreatic infiltration

    Measured: 2 months

  2. Histologic parameters

    % surface of iron deposit

    Measured: 2 months

  3. Histologic parameters

    % surface of fibrosis

    Measured: 2 months

  4. Histologic parameters

    % surface of acinoductal metaplasia

    Measured: 2 months

  5. Histologic parameters

    number of PanIN lesions

    Measured: 2 months y

  6. MRI parameters

    pancreatic fat content

    Measured: Day 1

  7. MRI parameters

    Diffusion coefficients (10-4 mm2/s)

    Measured: Day 1

  8. MRI parameters

    transverse magnetization relaxation rate

    Measured: Day 1I

  9. MRI parameters

    longitudinal magnetization relaxation rate

    Measured: Day 1

  10. MRI parameters

    visco-elastic parameters by measure of tissue stiffness (kPa)

    Measured: Day 1

  11. Biomarkers of pathways activation measured by immunohistochemistry on resected pancreatic parenchyma

    % expression of molecules involved in TGFb and orexin signaling

    Measured: 2 months

  12. Biomarkers of pathways activation measured by immunohistochemistry on resected pancreatic parenchyma

    % expression of the markers in inflammatory cells (CD8, IL6, Caspase, HNF6)

    Measured: 2 months

  13. Biomarkers of pathways activation measured by immunohistochemistry on resected pancreatic parenchyma

    % surface of acinoductal metaplasia

    Measured: 2 months

  14. Biomarkers of pathways activation measured by immunohistochemistry on resected pancreatic parenchyma

    % of stained cells

    Measured: 2 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Jul 2019
  2. Study start18 Jun 2019
  3. Primary completion31 May 2023
  4. Study completion31 May 2023

Why it stopped: Population difficult to recruit; number of enrolled patients sufficient for analyses.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Diagnosis
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
41 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04007640
Sponsor's protocol ID
2018-A02712-53
Acronym
PAIR-PANCREAS
Status last verified
Jul 2022
First submitted
16 Apr 2019
Last updated
12 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A study testing MRI with additional sequences, MRI and Left pancreatectomy or pancreaticoduodenectomy in people with Pancreatic Cancer, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 12 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: Population difficult to recruit; number of enrolled patients sufficient for analyses.). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Quantitative MRI parameters (time frame: Day 1). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Aug 2026.

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