Diagnosing Pancreatic Cancer Early Enough for Surgical Treatment

A team of pancreatic cancer researchers has found that by combining measurement of two blood biomarker proteins with determination of the current gold standard biomarker, CA 19-9, it was possible to detect pancreatic cancer at an early enough stage to save patients with surgery.

At early stages, pancreatic ductal adenocarcinoma (PDAC) can be successfully removed with surgery, but about 80% of patients are diagnosed with either locally advanced disease (stage III) or metastatic disease (stage IV), when surgery is no longer a curative option. Therefore, blood-based biomarkers for early detection of pancreatic cancer are urgently needed. Current biomarkers lack high sensitivity and specificity for population screening, and the gold-standard biomarker, CA 19‐9, also fails to demonstrate the predictive value necessary for early detection.

In previous work, investigators at the University of Texas MD Anderson Cancer Center identified a cluster of genes involved in cancer migration and then analyzed the proteins produced by those genes. Two of these proteins, plasma tissue factor pathway inhibitor (TFPI) and tenascin C (TNC-FN III-C), emerged as the strongest biomarker candidates.

In the current study, the investigators established that the TFPI/TNC-FN III-C migration signature added significantly to the predictive power of CA 19‐9 to detect PDAC at an early-stage when it is still surgically treatable.

“Adding these two biomarkers provided statistically significant improvement for all early stage cancer versus healthy controls as well as other subcohorts when used with the current gold standard biomarker, CA 19-9,” said senior author Dr. Ann Killary, professor of translational molecular pathology at the University of Texas MD Anderson Cancer Center. “Our goal is to identify more patients at those earlier, resectable stages, when treatment could lead to a five year survival rate of 30% or more, depending on stage. Only about 7% of patients survive for five years following diagnosis of the disease. In this population, our biomarker panel might prove very useful in early detection.”

The study was published in the February 27, 2017, online edition of the Journal of the National Cancer Institute.