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Pancreatic cancer has one of the lowest survival rates of all cancers. Often, people with the disease do not have noticeable symptoms until the tumour is already at a stage where it has started to spread and is difficult to treat. Researchers are looking for ways to diagnose pancreatic cancer while it is still in an early stage when it can be more successfully treated.
Researchers at Johns Hopkins School of Medicine in Baltimore recently published a study that found that a liquid biopsy that looks for a combination of cancer markers could be used to diagnose pancreatic cancer early.
Blood samples can provide information about cancer
Researchers are studying whether liquid biopsy, which looks for signs of cancer in blood or other bodily fluids, can be used to diagnose and monitor a variety of cancers.
In some cases, researchers look for genetic mutations, or changes, that are associated with cancer. In other cases, they look for specific proteins that are elevated in people with cancer. Liquid biopsies are currently used to monitor whether treatments are working, but they have a lot of potential to be used to for diagnosis, particularly for cancers like pancreatic cancer that are difficult to detect early.
Using current technology, detecting either genetic mutations or proteins separately is not sensitive or specific enough to be used to reliably diagnose cancer. In the new study, researchers combined the 2 approaches for an improved effect.
Genetic mutations and proteins in blood help to diagnose cancer
The researchers tested blood samples of people already diagnosed with pancreatic cancer for mutations in a gene called KRAS, often altered in the disease. They found that they could identify about 30% of pancreatic cancer cases just by looking for KRAS mutations in DNA in the blood.
To improve the sensitivity of the test, they studied whether looking at KRAS mutations along with a selection of proteins known to be elevated in people with pancreatic cancer could identify more people with the disease.
They found that this combination test could detect 64% of pancreatic cancer cases, more than any one component on its own. Importantly, the test also detected people with cancer who had no symptoms and people with the earliest stage of the disease, demonstrating that this combination test could have value for screening.
Combination approach is specific and sensitive
In order for liquid biopsy to be used for early detection and cancer screening, researchers need to develop tests that are highly specific to cancer to reduce the risk of misdiagnosing people who do not have the disease, while at the same time are highly sensitive to avoid missing cancers. Based on this study, an approach that looks for both a genetic mutation and a specific proteins satisfies both criteria.
This approach still needs to be tested in a larger study before it can be offered widely, and the researchers will continue to push this promising work forward. For a disease like pancreatic cancer, which often goes undetected until it’s too late to treat, liquid biopsy for early detection could be a life-saving tool.
Eileen Hoftyzer, BSc, and Carolyn Goard, PhD