A panel of four blood biomarkers, comprised of the previously identified pancreatic cancer biomarker CA 19-9 plus three new protein biomarkers, can successfully identify individuals with pancreatic cancer from those who have other pancreatic conditions, according to a study presented at the American Association for Cancer Research’s special conference on pancreatic cancer (May 18-21; New Orleans). Blood-based biomarkers could markedly improve the ability to identify early-stage pancreatic cancer. Most of the time, pancreatic cancer is identified too late for good outcomes, with only 10 percent of pancreatic patients presenting with localized disease. The previously identified CA 19-9 marker for pancreatic cancer has been of limited utility and is not detectable in 5 percent to 10 percent of subjects with fucosyltransferase deficiency. So researchers have undertaken further validation of a multimarker panel intended to complement CA 19-9. A training set of plasma samples from 138 pancreatic cancer patients and 81 controls (52 healthy subjects and 29 subjects with chronic pancreatitis) yielded a combination rule which was then tested in plasma samples from an independent cohort of 42 early-stage pancreatic cancer patients, 50 healthy controls, 29 subjects with chronic pancreatitis, and 14 subjects with benign pancreatic cysts. In these analyses, CA 19-9 […]
A panel of four blood biomarkers, comprised of the previously identified pancreatic cancer biomarker CA 19-9 plus three new protein biomarkers, can successfully identify individuals with pancreatic cancer from those who have other pancreatic conditions, according to a study presented at the American Association for Cancer Research’s special conference on pancreatic cancer (May 18-21; New Orleans).
Blood-based biomarkers could markedly improve the ability to identify early-stage pancreatic cancer.
Most of the time, pancreatic cancer is identified too late for good outcomes, with only 10 percent of pancreatic patients presenting with localized disease. The previously identified CA 19-9 marker for pancreatic cancer has been of limited utility and is not detectable in 5 percent to 10 percent of subjects with fucosyltransferase deficiency. So researchers have undertaken further validation of a multimarker panel intended to complement CA 19-9.
A training set of plasma samples from 138 pancreatic cancer patients and 81 controls (52 healthy subjects and 29 subjects with chronic pancreatitis) yielded a combination rule which was then tested in plasma samples from an independent cohort of 42 early-stage pancreatic cancer patients, 50 healthy controls, 29 subjects with chronic pancreatitis, and 14 subjects with benign pancreatic cysts.
In these analyses, CA 19-9 alone correctly identified as negative for pancreatic cancer blood samples from 76 percent to 78 percent of the time in the cohorts, compared with 90 percent to 94 percent for the four-biomarker panel. Negative predictive values (NPVs) at 98 percent sensitivity were substantially improved compared to CA 19-9 alone when identifying early-stage pancreatic cancer versus healthy controls and subjects with chronic pancreatitis or benign cysts (NPVs of the panel = 0.96, 0.95, and 0.88, respectively versus NPVs of CA 19-9 alone = 0.83, 0.83, and 0.88).
“Our biomarker panel was much better at distinguishing patients with pancreatic cancer from those who were healthy, had chronic pancreatitis, or had pancreatic cysts compared with CA 19-9 alone,” said lead study author Ayumu Taguchi, Ph.D., M.D., from MD Anderson Cancer Center (Houston). “This means that our panel has the potential to substantially reduce the number of patients who would have to undergo extremely invasive screening procedures.”
Taguchi tells DTET that the panel still requires further validation, including in prediagnostic samples. He plans to license the intellectual property behind the test.
Takeaway: While not ready for clinical use, the use of protein biomarkers along with CA 19-9 offers hope that a noninvasive test will be able to diagnose pancreatic cancer at an earlier stage, when improved outcomes are possible.
