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Simple Summary: Pancreatic cancer is the third leading cause of cancer deaths and is projected to become the second leading cause by 2030. Striking racial disparities in pancreatic cancer incidence and mortality rates exist nationally and in Florida, with higher rates among African Americans compared to other racial groups. Biological reasons for these disparities remain unexplained, primarily because most pancreatic cancer research has relied on biospecimens and data from Non-Hispanic Whites. Multidisciplinary teams from fifteen hospitals throughout the state of Florida have partnered together and with patients newly-diagnosed with pancreatic cancer to build the first state-wide biobanking infrastructure we know of that is dedicated to reducing the disproportionate burden of pancreatic cancer affecting African Americans. We describe important information on ascertainment and recruitment strategies and standard operating procedures developed to collect, process, store, and transfer biospecimens, medical images, and data from a diverse cohort of participants. The infrastructure described in this manuscript is intended to serve as a strong foundation for further research into biological, behavioral, socioeconomic, and environmental factors that may contribute to observed disparities and a starting point to develop interventions to tackle these factors. This multi-institutional infrastructure can serve as a prototype for the development of similar resources across the country and disease sites. Background: Well-annotated, high-quality biorepositories provide a valuable platform to support translational research. However, most biorepositories have poor representation of minority groups, limiting the ability to address health disparities. Methods: We describe the establishment of the Florida Pancreas Collaborative (FPC), the first state-wide prospective cohort study and biorepository designed to address the higher burden of pancreatic cancer (PaCa) in African Americans (AA) compared to Non-Hispanic Whites (NHW) and Hispanic/Latinx (H/L). We provide an overview of stakeholders; study eligibility and design; recruitment strategies; standard operating procedures to collect, process, store, and transfer biospecimens, medical images, and data; our cloud-based data management platform; and progress regarding recruitment and biobanking. Results: The FPC consists of multidisciplinary teams from fifteen Florida medical institutions. From March 2019 through August 2020, 350 patients were assessed for eligibility, 323 met inclusion/exclusion criteria, and 305 (94%) enrolled, including 228 NHW, 30 AA, and 47 H/L, with 94%, 100%, and 94% participation rates, respectively. A high percentage of participants have donated blood (87%), pancreatic tumor tissue (41%), computed tomography scans (76%), and questionnaires (62%). Conclusions: This biorepository addresses a critical gap in PaCa research and has potential to advance translational studies intended to minimize disparities and reduce PaCa-related morbidity and mortality. [ABSTRACT FROM AUTHOR]

Introduction: Cancer-associated cachexia (CC) is a progressive syndrome characterized by unintentional weight loss, muscle atrophy, fatigue, and poor outcomes that affects most patients with pancreatic ductal adenocarcinoma (PDAC). The ability to identify and classify CC stage along its continuum early in the disease process is challenging but critical for management., Objectives: The main objective of this study was to determine the prevalence of CC stage overall and by sex and race and ethnicity among treatment-naïve PDAC cases using clinical, nutritional, and functional criteria. Secondary objectives included identifying the prevalence and predictors of higher symptom burden, supportive care needs, and quality of life (QoL), and examining their influence on overall survival (OS)., Materials and Methods: A population-based multi-institutional prospective cohort study of patients with PDAC was conducted between 2018 and 2021 by the Florida Pancreas Collaborative. Leveraging patient-reported data and laboratory values, participants were classified at baseline into four stages [non-cachexia (NCa), pre-cachexia (PCa), cachexia (Ca), and refractory cachexia (RCa)]. Multivariate regression, Kaplan Meier analyses, and Cox regression were conducted to evaluate associations., Results: CC stage was estimated for 309 PDAC cases (156 females, 153 males). The overall prevalence of NCa, PCa, Ca, and RCa was 12.9%, 24.6%, 54.1%, and 8.4%, respectively. CC prevalence across all CC stages was highest for males and racial and ethnic minorities. Criteria differentiated NCa cases from other groups, but did not distinguish PCa from Ca. The most frequently reported symptoms included weight loss, fatigue, pain, anxiety, and depression, with pain significantly worsening over time. The greatest supportive care needs included emotional and physical domains. Males, Black people, and those with RCa had the worst OS., Conclusions: Using clinical, nutritional, and functional criteria, nearly one-quarter of the PDAC cases in our diverse, multi-institutional cohort had PCa and 62.5% had Ca or RCa at the time of diagnosis. The PCa estimate is higher than that reported in prior studies. We recommend these criteria be used to aid in CC classification, monitoring, and management of all incident PDAC cases. Findings also highlight the recommendation for continued emotional support, assistance in alleviating pain, and supportive care needs throughout the PDAC treatment journey., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Permuth, Park, Chen, Basinski, Powers, Gwede, Dezsi, Gomez, Vyas, Biachi, Cortizas, Crowder, Genilo-Delgado, Green, Greene, Gregg, Hoffe, Jiang, Kim, Vasudevan, Garcialopez De Llano, Menon, Mo, MorenoUrazan, Mok, Parker, Rajasekhara, Rasool, Sinnamon, Sparks, Stewart, Tardif, Tassielli, Teer, Tran, Turner, Vadaparampil, Whelan, Douglas, Velanovich, Karachristos, Legaspi, Meredith, Molina-Vega, Huguet, Arnoletti, Bloomston, Trevino, Merchant, Pimiento, Hodul, Malafa, Fleming, Judge, Jeong and Judge.)