BALTIMORE, September 17 — A new liquid biopsy blood test can detect pancreatic cancer at its earliest stages, including when it is still precancerous and potentially curable, according to researchers developing the technology. The test analyzes blood for biomarkers shed by tumors, a minimally invasive approach that could transform how doctors screen for a disease with the lowest survival rates of any major cancer. The pancreas is a glandular organ located behind the stomach that produces digestive enzymes and hormones such as insulin.
Pancreatic cancer is notoriously difficult to detect early because the pancreas sits deep within the abdomen and early tumors often cause no symptoms. Symptoms such as jaundice, abdominal pain, weight loss, and new-onset diabetes usually appear only after the cancer has advanced.
According to the American Cancer Society, pancreatic cancer has a five-year relative survival rate of just 11% overall, and approximately 90% of patients are diagnosed after the cancer has already spread to other organs, when treatment options are limited and the disease is typically incurable.
How the Test Works
The liquid biopsy detects circulating tumor DNA or other cancer-specific markers in a patient’s blood. Unlike traditional tissue biopsies, which require invasive procedures to obtain a sample of the tumor, liquid biopsies are minimally invasive and can be repeated easily. The test is designed to identify pancreatic cancer at the precancerous stage, known as pancreatic intraepithelial neoplasia, or at very early stages when the tumor is confined to the pancreas and has not spread.
At these stages, surgical removal of the tumor can be curative. The development involved identifying specific genetic mutations and epigenetic changes associated with pancreatic cancer, such as mutations in the KRAS, TP53, CDKN2A, and SMAD4 genes.
These mutations are found in the majority of pancreatic cancers and can be detected in cell-free DNA in the blood. The test also uses advanced machine learning algorithms to distinguish cancer-derived DNA from normal DNA, improving accuracy. Clinical validation studies have shown that the test can detect pancreatic cancer with high sensitivity and specificity, even in early-stage patients.
A study published in 2023 in the journal Nature Medicine reported that a liquid biopsy test detected pancreatic cancer with 95% sensitivity and 99% specificity in a cohort of patients. Another study presented at the 2024 American Society of Clinical Oncology Annual Meeting showed similar results.
Not Yet Widely Available
The test is not yet widely available. It is currently undergoing further validation in large-scale clinical trials, such as the National Cancer Institute’s Early Detection Research Network studies. The test is being developed by several companies and research institutions, including Grail, which is developing the Galleri test, and other biotech firms.
The Pancreatic Cancer Action Network has emphasized the importance of early detection and has launched initiatives like the Early Detection Initiative. The National Cancer Institute funds research on pancreatic cancer early detection.
The development of this test is a collaborative effort involving researchers from institutions such as Johns Hopkins University, the University of Pennsylvania, and the Mayo Clinic. Dr. Bert Vogelstein of Johns Hopkins, a pioneer in cancer genetics, has been involved in early work on liquid biopsies. The test’s potential to detect precancerous lesions is particularly exciting because it could allow for intervention before cancer even develops.
The new test could potentially shift the paradigm by enabling routine screening for high-risk individuals, such as those with a family history of pancreatic cancer, genetic syndromes like BRCA mutations, or chronic pancreatitis. The test is expected to be available for clinical use within the next few years, pending FDA approval.
The encouraging part is that this represents a major step forward in the fight against pancreatic cancer. Consult your doctor for medical advice.
