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Circulating Tumor DNA in the Blood May Help to Detect Pancreatic Cancer

by Madhumathi Palaniappan on December 19, 2016 at 3:01 PM
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Highlights

Pancreatic cancer can be identified by the presence of circulating tumor DNA in the blood samples of the patients, reveals a study published in the journal Clinical Cancer Research.


When there is an abnormal proliferation of cancer cells in the pancreas it might lead to pancreatic cancer. It is estimated to be the second leading cause of cancer-related death in the United States next to lung cancer by 2030. There is a rising prognosis for pancreatic cancer in the western countries while the prognosis is poor.

‘Pancreatic cancer can be diagnosed using circulating tumor DNA in the blood as a prognostic biomarker.’

Jean-Baptiste Bachet, MD, PhD, from the Gastroenterology and Digestive Oncology Department at Sorbonne University, and the Centre Universitaire des Saints-P�res, both in Paris, France, explained the challenges of conducting translational research for pancreatic cancer, since it is difficult to collect tumor samples from the patients and due to the limited availability of collected samples.

Around 10-15% of the patients need to remove the tumor during diagnosis. Identifying a biomarker is essential for patients with pancreatic cancer.

Research Study
The research team initiated the study five years ago by collecting blood samples from pancreatic cancer patients with the aim of identifying biomarkers to detect pancreatic cancer.

Blood samples from 135 patients with pancreatic cancer were analyzed, out of which 31 patients had resectable tumors, 36 had locally advanced disease (LA) and 68 had metastatic cancer which can spread to other parts of the body.

They extracted DNA from blood samples and used a NGS analysis method (Next Generation Sequencing) to detect low-allele frequency mutation. They can also be screened by picoliter droplet-based digital PCR (dPCR).

The presence of circulating tumor DNA is an independent biomarker in patients with advanced disease. It is also correlated with the stage and grade of pancreatic cancer.

Out of the 104 patients, 50 of them had detectable circulating DNA. After a period of 34.2 months, 76 of them died. The overall survival rate was 19months in patients who had no detectable circulating tumor DNA when compared to 6.5 months in patients with circulating DNA.

Based on the frequency of DNA mutations, there was a notable dose-response relationship with overall survival rate. 18.9 months for lowest in the three groups that were divided and 4.9 months in the highest.

Out of the 31 patients with resectable disease, 6 of them had detectable circulating tumor DNA. After a period of 33.3 months, 23 of them had recurrence and 13 of them died.

The disease-free survival was 17.6 months in patients with no detectable circulating tumor DNA when compared to 4.6 months with detectable DNA. The overall survival was 32.2 months versus 19.3 months.

Bachet said, "Our results demonstrate the utility of circulating biomarkers in subclassifying cancers and managing treatment."

"We need to confirm these results in prospective clinical trials to better assess the predictive value of this biomarker in light of the dynamic biological changes that occur during treatment."

Study Limitation
Blood samples from the patients were not collected before surgery. Therefore researchers failed to give data regarding pre-operative circulating tumor DNA.

Facts on Pancreatic Cancer

Symptoms of Pancreatic Cancer

References:

  1. What is pancreatic cancer? - ( http://www.cancer.org/cancer/pancreaticcancer/detailedguide/pancreatic-cancer-what-is-pancreatic-cancer)
  2. 15 Key Facts on Pancreatic Cancer - ( http://www.ecpc.org/edu/pancreas/159-edu/pancreas/249-15-key-facts-on-pancreatic-cancer)
  3. Signs and symptoms of pancreatic cancer - ( http://www.cancer.org/cancer/pancreaticcancer/detailedguide/pancreatic-cancer-signs-and-symptoms)


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