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Vol. LXVI, No. 3
January 31, 2014

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Blood Test Identifies Early Pancreatic Cancer

Dr. Nita Ahuja of Johns Hopkins University led the team of investigators.
Dr. Nita Ahuja of Johns Hopkins University led the team of investigators.
In a finding that holds key clinical implications, National Cancer Institute-supported researchers in Baltimore have devised a simple blood test that rapidly and accurately detects the earliest stage of pancreatic cancer. If the results of the study hold up in additional trials, it could lead to earlier diagnosis and improved prognosis for those afflicted with the disease, which took the lives of more than 37,000 Americans in 2011.

Cancer of the pancreas (a 6-inch organ that lies between the stomach and the backbone) is a particularly aggressive carcinoma with a low rate of survival. It is the fourth leading cause of cancer-related death in the U.S.; only 5 percent of patients are alive 5 years after diagnosis. This is partly because early symptoms are usually vague or misinterpreted; diagnosis and treatment usually begin only after the tumor has already spread. Additionally, there has been no improvement in survival rates for the disease over the past three decades. At present, there are no detection methods or medical procedures that can reliably spot pancreatic cancer in its earliest form.

Reporting in the journal Clinical Cancer Research, Dr. Nita Ahuja, associate professor of surgery and oncology at Johns Hopkins University, led a team of investigators who analyzed the tissue samples of 201 patients—143 had pancreatic cancer and 30 patients had pancreatitis (a noncancerous inflammation of the pancreas). The remaining samples came from patients without cancer or with a pre-malignant form of the condition.

“We were able to detect two genes in DNA that correlated significantly with the development of early pancreatic cancer. No one else has tried this—it’s a first-of-its-kind study,” noted Ahuja. Most prior tests have focused on later stages, when pancreatic cancer has already spread and is too advanced to treat effectively. However, the findings involving two blood biomarkers (BCN1 and ADAMST1) were particularly strong and occurred in the early stages of pancreatic cancer, she explained. Using the two markers combined, she added, the genetic alterations occurred in 97 percent of patients in stage 1 of the disorder.

Will this diagnostic test get from bench to bedside? “Yes, hopefully—my goal is to get it into the clinic,” Ahuja said, adding that it first needs to be replicated in follow-up investigations. “We want to extend it to a larger set of patients both with cancer and with other noncancerous conditions.”

If the findings hold up, she added, “We would only advocate patients get tested if they are at high risk for the disease, that is, if there is a history of extensive smoking, pancreatitis or a genetic inheritance (family history) of pancreatic cancer.”

An additional piece of good news is that the procedure is cost-effective and therefore could be repeated as often as necessary for at-risk patients.

Ahuja and her team hope to make further progress against this deadliest of cancers.

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