MicroRNA Panel Shows Early Potential as Biomarker of Pancreatic Precancers
Assessing blood plasma levels of certain microRNAs (miRNAs) distinguished individuals with noninvasive pancreatic precancers from healthy individuals and discriminated between patients with high-risk and low-risk neoplasms, according to a preliminary, proof-of-principle study published by Permuth-Wey et al in Cancer Prevention Research.
“Pancreatic cancer is the fourth leading cause of cancer-related death in the United States,” said Jennifer Permuth-Wey, PhD, Assistant Member in the Departments of Cancer Epidemiology and Gastrointestinal Oncology at the Moffitt Cancer Center. “It is typically diagnosed at a late stage because there are currently no accurate methods to diagnose pancreatic cancer early. Noninvasive tests are needed to accurately detect precancerous lesions of the pancreas, so that personalized risk assessment and care can be provided.”
“Our study shows that new, relatively inexpensive digital technology could reliably measure miRNAs in blood plasma from individuals newly diagnosed with pancreatic cancer precursors called intraductal papillary mucinous neoplasms,” continued Dr. Permuth-Wey. “However, the results are preliminary and much more research is needed to determine if a miRNA-based blood test could help diagnose pancreatic cancer earlier or more effectively than current methods.”
Study Details
Dr. Permuth-Wey explained that the main goals of the study were to measure miRNAs in the blood and determine whether a set of miRNAs could distinguish patients with intraductal papillary mucinous neoplasms from healthy individuals. Additionally, researchers aimed to discover whether a set of miRNAs could discriminate between patients with high-risk intraductal papillary mucinous neoplasms that need to be surgically removed and those with low-risk intraductal papillary mucinous neoplasms that can be monitored.
Researchers first used nCounter technology to measure the levels of 800 miRNAs in plasma samples obtained preoperatively from 44 patients who underwent surgery to remove intraductal papillary mucinous neoplasms surgically and from 25 healthy individuals. Then, they identified a panel of 30 miRNAs that distinguished individuals with intraductal papillary mucinous neoplasms from those who were healthy, with an area under the curve value of 0.74. A perfect diagnostic test has an area under the curve of 1.0; a useless or nondiscriminating test has an area under the curve of 0.5, which is no better than chance alone.
Researchers also identified a panel of five miRNAs that discriminated between patients with high-risk and low-risk intraductal papillary mucinous neoplasms, with an area under the curve of 0.73. “To be able to distinguish between these two sets of patients is important clinically,” said Mokenge Malafa, MD, Department Chair and Program Leader for the Gastrointestinal Tumor Program at Moffitt Cancer Center. “It would help personalize care such that high-risk intraductal papillary mucinous neoplasms that warrant resection are properly identified, while individuals with low-risk intraductal papillary mucinous neoplasms are spared the substantial risks associated with unnecessary surgery.”
According to Dr. Permuth-Wey, limitations of the study include the small number of samples analyzed and that the accuracy of the 30-miRNA panel and the five-miRNA panel was 74% and 73%, respectively, when many researchers think that accuracy greater than 90% may be needed for a test to be clinically useful. She went on to note that large-scale, multicenter studies with rigorous designs and incorporation of other types of information, such as data from imaging scans and laboratory tests offered as part of clinical care, are needed to overcome these limitations and further explore the potential for miRNAs to be utilized clinically as markers for the early detection of pancreatic cancer.
Dr. Permuth-Wey is the corresponding author of the Cancer Prevention Research article.
This study was supported by the American Cancer Society and the National Cancer Institute. Drs. Permuth-Wey and Malafa are among the named inventors on a provisional patent application filed on the basis of results from this study.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
