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Proteins Found in Urine May Serve as Biomarker for Early-Stage Pancreatic Cancer

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Key Points

  • The study, which looked at 488 urine samples, selected three proteins—LYVE1, REG1A, and TFF1—for closer examination.
  • Patients with pancreatic cancer were found to have increased levels of each of the three proteins when compared to urine samples from healthy patients, while patients suffering from chronic pancreatitis had significantly lower levels than cancer patients.
  • When combined, the three proteins formed a robust panel that can detect patients with stage I to II pancreatic cancer with over 90% accuracy, improving chances for early detection and increased overall survival.

A team of researchers at Barts Cancer Institute­­–Queen Mary University of London has discovered a combination of three proteins found at high levels in urine that can accurately detect early-stage pancreatic cancer. The discovery could lead to a noninvasive, inexpensive test to screen people at high risk of developing the disease.

The study, published by Radon et al in Clinical Cancer Researchand funded by the Pancreatic Cancer Research Fund, has shown that the three-protein “signature” can both identify the most common form of pancreatic cancer when still in its early stages and distinguish between this cancer and the inflammatory condition chronic pancreatitis.

Study Details

The study looked at 488 urine samples: 192 from patients with pancreatic cancer, 92 from patients with chronic pancreatitis, and 87 from healthy volunteers. A further 117 samples from patients with other benign and malignant liver and gallbladder conditions were used for further validation.

Around 1,500 proteins were found in the urine samples, with approximately half being common to both male and female volunteers. Of these, three proteins—LYVE1, REG1A, and TFF1—were selected for closer examination, based on biologic information and performance in statistical analysis.

Patients with pancreatic cancer were found to have increased levels of each of the three proteins when compared to urine samples from healthy patients, while patients suffering from chronic pancreatitis had significantly lower levels than cancer patients. When combined, the three proteins formed a robust panel that can detect patients with stage I to II pancreatic cancer with over 90% accuracy.

Easy, Inexpensive, Crucial Early-Detection Tool

With few specific symptoms even at a later stage of the disease, more than 80% of people with pancreatic cancer are diagnosed when the cancer has already spread. This means they are not eligible for surgery to remove the tumor, which is currently the only potentially curative treatment.

Lead researcher Tatjana Crnogorac-Jurcevic, MD, PhD, said, “We've always been keen to develop a diagnostic test in urine, as it has several advantages over using blood. It's an inert and far less complex fluid than blood, and can be repeatedly and noninvasively tested. This is a biomarker panel with good specificity and sensitivity, and we’re hopeful that a simple, inexpensive test can be developed and be in clinical use within the next few years.”

Although there is no universal cause of pancreatic cancer, people at higher risk of developing the disease include those with a family history of pancreatic cancer, heavy smokers, the obese, and people over 50 with new-onset diabetes.

The team is hoping to conduct further tests on urine samples from people in high-risk groups, to further validate the study findings. Dr. Crnogorac-Jurcevic is also keen to access samples of urine collected from volunteers over a period of 5-10 years. By examining samples from donors who went on to develop pancreatic cancer, this longitudinal information will allow the researchers to see if the 3-biomarker signature is present during the latency period.

“For a cancer with no early-stage symptoms, it's a huge challenge to diagnose pancreatic cancer sooner, but if we can, then we can make a big difference to survival rates,” said coauthor and Director of Barts Cancer Institute, Nick Lemoine, MD, PhD, FRCPath, FMedSci. “With pancreatic cancer, patients are usually diagnosed when the cancer is already at a terminal stage, but if diagnosed at stage II, the survival rate is 20%. At stage I, the survival rate for patients with very small tumors can increase up to 60%.”

Dr. Crnogorac-Jurcevic is the corresponding author for the Clinical Cancer Research article.

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®.


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