Pancreatic cysts are a common and often incidental finding on abdominal imaging. These cysts are important to monitor because a minority of them will transform into pancreatic cancer over time. The EA2185 clinical trial launched in 2020 to compare the clinical impact and cost effectiveness of two common pancreatic cyst surveillance strategies. Since then, evidence has emerged that both surveillance strategies are comparable in terms of clinical effectiveness.

In August 2025, the trial resumed patient accrual after a temporary suspension to process an amendment establishing a new goal: to determine the utility of blood-based and/or radiomic (imaging) biomarkers for identifying patients at elevated risk of their pancreatic cysts becoming malignant.

Guidance for Participating Clinical Sites

Patients enrolled prior to addendum #5 must review and sign the consent addendum within six months of the date of local implementation. Patient notification may follow local institutional standards, including remote consent if permissible. Please refer to the addendum #5 CIRB application posted on the CTSU website for additional information.

If patients enrolled before addendum #5 agree to continue in the study, they will be followed as outlined in Appendix IV of the protocol. They will continue to follow the surveillance schedule per prior randomization, complete patient-reported outcomes per amendment #4, and provide optional (per prior consent) and mandatory imaging and specimen submissions.

The new changes in addendum #5 apply only to newly registered patients. These participants will no longer be randomized, and treating providers may dictate surveillance (as long as it meets the minimum study requirement). All new enrollees will undergo mandatory blood collection, which was previously optional, in addition to imaging collection.

The new primary endpoint of the study is to assess the time until worrisome features and/or high-risk stigmata develop, measured as time since enrollment. The trial plans to enroll 750 patients, all of whom will be followed for approximately 5 years from the date of randomization.

Learn more about EA2185 at ecog-acrin.org.

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The study chair for this trial is David Weinberg, MD, MSc (Fox Chase Cancer Center). The study co-chairs are Herbert Zeh, MD (UT Southwestern), Paul Moayyedi, MD (McMaster University), James Scheiman, MD (University of Michigan), Hanna Zafar, MD, MHS (University of Pennsylvania), Aatur Singhi, MD, PhD (University of Pittsburgh), Stanley Hamilton, MD (in transition), Flavio Rocha, MD (Oregon Health & Science University), and Xin Yao, MD (ThedaCare Regional Cancer Center).