A novel screening platform flagged more than 95% of stage I pancreatic cancers, in addition to other early-stage malignancies, according to a pilot study published by Hinestrosa et al in Nature Communications Medicine. If validated by future studies, the approach may offer a new way to detect the third-leading cause of U.S. cancer deaths in 2020.
The study of 139 patients with stage I and II cancer and 184 controls is the first clinical test of a platform technology called high-conductance dielectrophoresis, developed at Moores Cancer Center at UC San Diego Health 12 years ago. It detects extracellular vesicles, which contain tumor proteins that are released into circulation by cancer cells as part of a poorly understood intercellular communication network. Artificial intelligence–enabled protein marker analysis is then used to predict the likelihood of malignancy.
In addition to detecting 95.5% of stage I pancreatic cancers, the approach flagged 74.4% of stage I ovarian cancers and 73.1% of pathologic stage IA lethally aggressive serous ovarian adenocarcinomas—all with more than 99% specificity—illustrating the potential value of this technology for early cancer detection.
“The pancreatic cancer result is particular promising,” said Scott M. Lippman, MD, Director of Moores Cancer Center, Principal Investigator of the Stand Up To Cancer–Lustgarten Foundation Pancreatic Cancer Interception Dream Team, and co–senior author of the paper. “These results are five times more accurate in detecting early-stage cancer than current liquid biopsy multicancer detection tests.”
Liquid biopsy tests produce promising results for cancer therapy monitoring and disease relapse, Dr. Lippman said. However, he continued, “they can cause real harm to otherwise healthy people when used for early-disease screening due to unacceptably high false-positive rates that lead to diagnostic tests that are not only expensive, but often dangerous.”
Benefits of Early Detection
Early cancer detection research has yielded tremendous health benefits, Dr. Lippman said, resulting in screening methods that detect cervical, breast, and colorectal cancers when they are highly curable. Currently, however, only 5% of pancreatic cancers are diagnosed as stage I, and only 10% in time for effective surgery. In 2020, 46,774 Americans died of pancreatic cancer, according to the Centers for Disease Control and Prevention.
“Pancreatic cancer has the lowest 5-year relative survival rate of all major cancer[s] … and is the only one for which both the incidence and death rates are increasing,” said Andrew Lowy, MD, Clinical Director for Cancer Surgery at UC San Diego Health Moores Cancer Center and Chief of the Division of Surgical Oncology at UC San Diego School of Medicine. “Pancreatic cancer is notoriously difficult to detect early, at a stage when surgical resection, the only curative therapy, is possible. At this stage, patients typically have few if any symptoms.”
If study results are validated, Dr. Lippman said, “we can greatly reduce the mortality from this disease which will soon become the second-leading cause of cancer mortality in the U.S.”
Disclosure: Funding for this research came, in part, from the National Institutes of Health and the Stand Up To Cancer–Lustgarten Foundation Pancreatic Cancer Interception Dream Team Translational Cancer Research Grant. For full disclosures of the study authors, visit nature.com.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®.