Pancreatic Cancer Blood Test May Enable Early Detection

A new blood test being developed by researchers at Tampa’s Moffitt Cancer Center may hold the key to early detection of one of the deadliest forms of cancer.

Researchers there say they have isolated potential markers in the blood that can help pinpoint people with premalignant pancreatic lesions known as “intraductal papillary mucinous neoplasms,” or IPMNs. These lesions may serve as an early sign that development of pancreatic cancer is likely. The findings of Moffitt’s “proof of principle” study were published in Thursday’s issue of Cancer Prevention Research.

“One promising strategy to reduce the number of people affected by pancreatic cancer is to identify and treat premalignant pancreatic lesions,” study author Jennifer Permuth-Wey, Ph.D., M.S., assistant member in the Departments of Cancer Epidemiology and Gastrointestinal Oncology at Moffitt, said in a media release. “IPMNs are established precursor lesions to pancreatic cancer that account for approximately half of all asymptomatic pancreatic cysts incidentally detected by computerized tomography (CT) scans or magnetic resonance imaging (MRI) in the U.S. each year.”

While CT and MRI scans can pick up these lesions early, the problem is that not every lesion found is indicative of pancreatic cancer development. The lesions can be low- or high-risk, meaning they may or may not develop into full-blown pancreatic cancer. As it stands right now, the only way to tell for sure is to surgically remove them. That in itself is problematic, researchers say.

Surgical removal can lead to an increased risk of complications, such as diabetes and even death.

“Alternatively, not removing the IPMN(s) could lead to a missed opportunity to prevent high-risk lesions from developing into invasive pancreatic cancer,” the media release stated.

The Stakes Are High

Pancreatic cancer is considered the fourth most common cause of cancer-related deaths in America, according to the American Cancer Society. The disease has the lowest survival rate of all types of cancer with only a 6 percent 5-year survival rate. An estimated 48,900 people are diagnosed with pancreatic cancer in America each year. A total of 40,560 people are expected to die from the disease in 2015 alone, the American Cancer Society projects.

The dismal survival figures are due in large part to the difficultly doctors currently have in detecting pancreatic cancer in its earliest, most treatable stages, Moffitt said.

“Symptoms typically appear once the disease is at a very late stage,” Permuth-Wey told Patch.

At that point, successful treatment is unlikely as evidenced by the mortality figures associated with the disease.

A Possible Solution in the Making

Moffitt researchers are working on a way to develop a fast, affordable blood test that can help doctors determine – without the need for potentially dangerous surgery – if pancreatic lesions are low or high risk. The test, researchers say, could open the door to earlier detection and more successful treatment options.

The test relies on the study of microRNAs, or miRNAs, which are small molecules that regulate genes critical in the development and progression of cancer.

“Using new digital technology, we compared the expression patterns of miRNAs in the blood and discovered a set of 30 miRNAs that differentiated between IPMN patients and healthy volunteers,” senior study author Mokenge Malafa, M.D, F.A.C.S., department chair and program leader for Moffitt’s Gastrointestinal Oncology Program, explained. “We also identified five miRNAs that could distinguish between high-risk IPMNs and low-risk IPMNs.”

Those five miRNAs might pave the way for early detection.

“The hope is that in the not-so-distant future a miRNA-based blood test can be used in conjunction with imaging features and other factors to aid the medical team in accurately predicting disease severity of IPMNs and other pancreatic cysts at the time of diagnosis or follow-up so that more informed personalized medical management decisions can be made,” Permuth-Wey said.

Should further research support the use of a blood test to detect miRNAs to help diagnose pancreatic cancer, Permuth-Wey said it’s unlikely the test would be used for large-scale screening within the general population.

“This is because pancreatic cancer is rare and it wouldn’t be time or cost-effective to offer such a test,” she told Patch. “For this test to be most useful, it should be targeted towards groups at higher risk for pancreatic cancer, such as those with a family history of and/or an inherited susceptibility to the disease, those with IPMNs and other types of pancreatic cysts, and possibly those with a personal history of chronic pancreatitis or diabetes.”

The Next Steps

Before Moffitt’s findings can be used to develop a blood test, more research is necessary. Plans are already in place to proceed with further study.

Funding from the state of Florida and the new Florida Academic Cancer Center Alliance will enable additional research on pancreatic lesions in cooperation with the University of Florida Health Cancer Center and the University of Miami/Sylvester Comprehensive Cancer Center, Moffitt announced. The new partnership, called the Florida Pancreas Collaborative, is the first statewide multi-cancer center collaboration focused on IPMNs.

“Considering that Florida ranks second in the number of pancreatic cancer deaths that occur each year and the fact that pancreatic cancer is projected to surpass breast, prostate, and colorectal cancer and become the second leading cause of cancer deaths by 2030, we are thrilled that our state is committed to investing in pancreatic cancer research now,” Permuth-Wey said.

While the newly formed partnership will take the research forward, Wey said it’s the hope to partner with other institutions down the road, as well.

“To make major strides, much more funding will be needed from federal and non-federal agencies as well as private funders or foundations who are committed to early detection research for pancreatic cancer,” she said. “Individuals newly diagnosed with pancreatic cysts or other conditions of the pancreas as well as other individuals who may be at increased risk to develop pancreatic cancer are also encouraged to contribute information and biological specimens such as blood for research projects such as these.”

It is unclear how long it might take for Moffitt’s findings to result in a blood test that could be used by doctors to help identify pancreatic cancer.

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