A novel blood test may aid physicians in the earlier detection of pancreatic ductal adenocarcinoma and potentially improve survival rates for the disease, according to a recent study published by Montoya et al in Science Translational Medicine.
Background
Pancreatic ductal adenocarcinoma is the most common and aggressive type of pancreatic cancer. The disease is often diagnosed at an advanced stage, when treatment options are limited. Although current tests such as CA 19-9 are effective at indicating prognosis, they aren’t sensitive enough for early-stage detection.
“The problem with pancreatic cancer is that we often catch it too late,” explained senior study author Jared Fischer, PhD, Assistant Professor of Molecular and Medical Genetics at the School of Medicine and a scientist at the Cancer Early Detection Advanced Research Center at the Knight Cancer Institute at the Oregon Health & Science University.
Study Methods and Results
In this study, researchers developed the protease activity–based assay using a magnetic nanosensor (PAC-MANN) test. They created the noninvasive test with the blood samples of 350 patients who had pancreatic cancer, were at high risk of developing the disease, or were controls. The researchers then examined certain proteins, specifically proteases, in the blood that became more active in patients with pancreatic ductal adenocarcinoma.
“Our goal with PAC-MANN is to give clinicians a tool that can detect the disease much earlier, when more treatment options are available, and there is a better chance of survival,” Dr. Fischer stated.
The researchers found that the PAC-MANN test was capable of using a small blood sample to detect changes in protease activity. The test was able to correctly distinguish patients with pancreatic ductal adenocarcinoma from healthy patients and those with noncancerous pancreatic issues 98% of the time. It also helped identify early-stage cancer with 85% accuracy when used along with the CA 19-9 test.
Further, the researchers demonstrated that the PAC-MANN test could track treatment efficacy. Following surgery, they observed a decrease in protease activity, suggesting the test may help to monitor treatment success.
“This test isn’t just about detection; it could also help us measure how well treatments are working and guide therapeutic options. If we can track a patient’s response to therapy in real time, we can make better treatment decisions and improve outcomes,” Dr. Fischer revealed.
Unlike traditional tests, the PAC-MANN test required only a tiny blood sample and provides a simple fluorescent readout, making it a quick and accessible option for screening.
“The big difference with this test is the cost: It takes only 8 microliters of blood and 45 minutes to run the test at a cost of less than a penny per sample. This could easily be used in rural and underserved settings, where traditional tests are not or cannot be used,” proposed lead study author, Jose L. Montoya Mira, PhD, a research engineer at the Cancer Early Detection Advanced Research Center at the Knight Cancer Institute at the Oregon Health & Science University.
Conclusions
The researchers highlighted that the PAC-MANN test could address gaps in the early detection of pancreatic ductal adenocarcinoma. “Our test could be used for [patients] at high risk of pancreatic cancer, which is not targeted by current tests,” stressed Dr. Montoya Mira. “It allows for a more robust and less invasive screening, unlike an endoscopic ultrasound and other liquid biopsy tests that require large volumes of blood, thus allowing our test to be performed more frequently for earlier detection,” he underscored.
The researchers plan to conduct additional trials involving patients at high risk of developing pancreatic cancer. If these early findings are validated further in clinical trials, the PAC-MANN test could become a valuable tool for detecting pancreatic cancer sooner, giving patients more treatment options and improving survival.
“Hopefully, this is one step toward ending cancer as we know it,” Dr. Fischer concluded.
Disclosure: The research in this study was supported by Cancer Early Detection Advanced Research Center grants and by a National Cancer Institute of the National Institutes of Health award. For full disclosures of the study authors, visit science.org.
