In a multidisciplinary study from the University of Pennsylvania, a liquid biopsy that screens for a panel of biomarkers was more accurate at detecting the most common form of pancreatic cancer than any known biomarker alone, and the same test was also more accurate than medical imaging at staging the disease.1
Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer deaths. The overall 5-year survival rate is just 9%, and most patients live less than 1 year following their diagnosis. One of the biggest challenges is catching the disease before it has progressed or spread. If the disease is caught early, patients may be candidates for surgery to remove the cancer, which can be curative. For patients whose disease has spread, there are currently no curative treatment options.
“Right now, the majority of patients who are diagnosed already have metastatic disease, so there is a critical need for a test that can not only detect the disease earlier, but also accurately tell us who might be at a point where we can direct them to a potentially curative treatment,” says study cosenior author Erica L. Carpenter, MBA, PhD, director of the liquid biopsy laboratory and a research assistant professor of medicine at the University of Pennsylvania.
The panel of biomarkers researchers used for the test included carbohydrate antigen 19-9 (CA19-9) and KRAS mutational burden, which are known to be associated with PDAC. In a blinded test group of 47 patients (20 with PDAC, 27 who were cancer free), the test was 92% accurate in its ability to detect disease, which outperforms the best known biomarker, CA19-9 alone (89%).
The researchers then used samples from the 25 patients who imaging showed did not have metastatic disease. The Penn test was 84% accurate in determining disease staging, which is significantly higher than imaging alone (64%).
While the test still needs to be validated in a larger cohort, researchers say they are excited by the promise of what it could potentially mean for a patient population in need of this kind of advancement.
“If validated, this test could not only provide a key tool for at-risk patients, but also a monitoring tool for patients with certain known risk factors like BRCA mutations,” Carpenter says.
1. Yang Z, LaRiviere MJ, Ko J, et al. A multianalyte panel consisting of extracellular vesicle miRNAs and mRNAs, cfDNA, and CA19-9 shows utility for diagnosis and staging of pancreatic adenocarcinoma. Clin Cancer Res. Epub April 16, 2020; doi: 10.1158/1078-0432.CCR-19-3313.
Featured image: Photo courtesy University of Pennsylvania.