According to investigators at the Moffitt Cancer Center, Tampa, Fla, the discovery of new biomarkers has brought researchers one step closer to devising an approach for the early detection of pancreatic cancer.

Pancreatic cancer affects approximately 46,000 people in the United States each year, and ranks fourth among the leading causes of cancer-related deaths. Only about 6% of individuals with pancreatic cancer will live 5 years after their diagnosis. One reason for this high mortality rate is the lack of effective tools to detect pancreatic cancer early enough to allow its surgical removal. But study findings published in the January 21 edition of PLoS One identify new biomarkers for pancreatic cancer that may lead to earlier diagnosis and intervention.1

Permuth-Wey

Jennifer Permuth-Wey, PhD, Moffitt Cancer Center

Similar to the development of colon cancer from precancerous polyps, pancreatic cancer can develop from precursor lesions called intraductal papillary mucinous neoplasms (IPMNs), a type of pancreatic cyst that can be detected by computed tomography (CT) scans and magnetic resonance imaging (MRI). IPMNs can be benign (low-risk) or malignant (high-risk), but it is extremely challenging to accurately differentiate between these two possibilities by imaging or blood tests.

Currently, the only way to determine the severity of an IPMN is by surgically removing it. However, such procedures are associated with serious risks, including long-term diabetes and death. Alternatively, if physicians decide to watch the progression of an IPMN over time, they may miss an opportunity to cure a patient who may have a potentially life-threatening disease.

Moffitt researchers studied biomarkers called microRNAs to see which may be associated with high-risk IPMNs that warrant more immediate surgical removal. “MicroRNAs are small molecules that work as ‘master-regulators,’ controlling numerous cancer-related processes in the body,” says first author Jennifer Permuth-Wey, PhD, applied research scientist and molecular epidemiologist in the cancer epidemiology program at Moffitt. “MicroRNAs can be detected in tumor tissues and bodily fluids such as blood, and a growing body of evidence suggests they are promising biomarkers of early pancreatic cancer.”

Malafa

Mokenge Malafa, MD, Moffitt Cancer Center

The researchers analyzed surgically removed IPMN tissue from patients who had previously been diagnosed and treated at Moffitt. They discovered that six microRNAs could distinguish between high-risk and low-risk IPMNs. “We also provided evidence that the six microRNAs may contribute to pancreatic cancer progression,” says senior author Mokenge P. Malafa, MD, FACS, department chair and program leader for Moffitt’s gastrointestinal oncology program.

“The hope is that this line of research may eventually lead to a microRNA-based blood test that could be used in conjunction with imaging features and other factors to aid the medical team and patient in accurately predicting disease severity at the time of IPMN diagnosis or follow-up,” says Permuth-Wey.

“Importantly, this research may also help foster the development of new prevention and early detection strategies for pancreatic cancer,” adds Malafa.

A patent for this work entitled “MicroRNA Assay to Assess Malignancy Risk of Pancreatic Lesions” has been filed (docket number 13MB078PR). For further information, visit Moffitt Cancer Center.

REFERENCE

1. Permuth-Wey J, Chen YA, Fisher K, et al. A genome-wide investigation of microRNA expression identifies biologically meaningful microRNAs that distinguish between high-risk and low-risk intraductal papillary mucinous neoplasms of the pancreas. PLoS One. 2015; 10(1):e0116869; doi: 10.1371/journal.pone.0116869. Published online January 21, 2015.