2 New Tests Detect Hard-to-Diagnose Pancreatic Cancer with 95 Percent Accuracy

A new cancer screening platform, according to a study in Nature Communications Medicine, can detect more than 95% of stage-one pancreatic cancers. If the results are confirmed in further studies, this new approach will offer a new way to detect pancreatic cancer early; it is the third leading cause of cancer-related death in developed countries.

Early Diagnosis by Detecting Proteins Between Cancer Cells

The study, involving 139 patients with stage-one and stage-two pancreatic cancer and 184 controls, is the first clinical trial of a technology platform called high-conductance dielectrophoresis, developed 12 years ago at San Diego Health, Moores Cancer Center. The platform detects extracellular vesicles (EVs) containing tumor proteins that cancer cells release into circulation as part of an intercellular communication network that is not yet clearly understood. AI-enabled protein marker analysis is then used to predict the likelihood of cancer.

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In addition to detecting 95.5% of stage-one pancreatic cancers, the approach can detect 74.4% of stage-one ovarian cancers. All have greater than 99% specificity. This demonstrates the technology's potential value for early-stage cancer detection.

Scott M. Lippman, director of Moores Cancer Center, principal investigator of the Stand Up To Cancer–Lustgarten Foundation Pancreatic Cancer Prevention Dream Team, and lead author of the published paper, explained that “These results for early diagnosis of pancreatic cancer are especially promising. Compared with liquid-biopsy multi-cancer detection tested for early-stage cancer detection, these results are 5 times more accurate.”

Lippman said liquid biopsy tests have shown promising results in areas such as monitoring cancer treatment and disease recurrence, “but, on the other hand, they can harm healthy people when used for early-stage disease screening because of unacceptably high false-positive rates, leading to diagnostic tests that are not only costly but also burdensome.”

Lippman emphasized that, for early cancer detection, current cancer screening is available for cervical, colorectal, breast, and lung cancers, and that early-detection screening for these cancers provides major health benefits. Currently, only about 5% of pancreatic cancers are diagnosed at stage one, and only 10% are diagnosed in time for effective surgery.

Andrew Lowy, clinical director of cancer surgery at San Diego Health, Moores Cancer Center, and chair of the Department of Surgery at San Diego School of Medicine, said, “Pancreatic cancer has the lowest 5-year survival rate among all leading causes of cancer-related death and is the only cancer type in which both incidence and mortality rates are increasing .” “Pancreatic cancer is notoriously difficult to detect at an early stage when surgical resection, the only known curative treatment, is possible.”

Lipmann said that, if the study results are confirmed, they could “dramatically reduce mortality (the death rate) from this disease, which will soon become the second leading cause of cancer-related death in the United States.”

Multi-Biomarker Analysis

A preprint of another study led by Prof Dr. Matthew Firpo of the University of Utah in Salt Lake City was published in medRxiv. In their study, announced under the title “A Multi-Analyte Serum Biomarker Panel for Early Detection of Pancreatic Adenocarcinoma,” the researchers say this blood test combines robust individual analyses of 31 biomarkers, including serum biomarkers such as CEA and CA 19-9, to distinguish patients with early-stage pancreatic ductal adenocarcinoma from healthy people with high accuracy.

The team first examined blood biomarkers associated with cancerous tumors or early-stage pancreatic cancer. The 31 biomarkers meeting the criteria needed for an accurate diagnosis were measured in 182 patients with early-stage pancreatic cancer, 194 patients with benign pancreatic tumors, and 461 healthy controls. The test was validated in 40 controls, 73 people with benign pancreatic cancer, and 73 people with early- and advanced-stage pancreatic cancer. The biomarkers were involved in angiogenesis, apoptosis, the immune response, and other processes.

The analysis showed 92% accuracy in distinguishing people with pancreatic ductal adenocarcinoma (classic pancreatic cancer) from those without it and 94.4% accuracy in distinguishing people with pancreatic ductal adenocarcinoma from healthy controls; the validation set showed 91.9% and 92.5% accuracy, respectively.

Both studies represent developments playing a critical role in early pancreatic cancer detection. Unfortunately, 65% of patients with pancreatic ductal adenocarcinoma present to hospital at a stage too late for resection. For this disease, which has no symptoms to help detect it early, an affordable blood test could substantially increase the number of patients eligible for curative surgery.