miRNA-based Blood Test May Detect Early Pancreatic Cancer

Jenny Permuth Wey, PhD, MS Assistant Member Departments of Cancer Epidemiology and Gastrointestinal Oncology Moffitt Cancer Cente
MedicalResearch.com Interview with:
Jenny Permuth Wey, PhD, MS
Assistant Member
Departments of Cancer Epidemiology and Gastrointestinal Oncology
Moffitt Cancer Center

 

Medical Research: What is the background for this study? What are the main findings?

Dr. Wey: Pancreatic cancer is one of the deadliest cancers world-wide. It is currently the fourth leading cause of cancer-related deaths in the United States, and is predicted to become the second leading cause by 2030. Currently there are no accurate methods to diagnose pancreatic cancer early when a patient may be eligible for surgery to remove the tumor and hopefully survive longer. To beat this disease, early detection is key, and our team has dedicated efforts to studying pancreatic cancer in its ‘precancerous’ state because we and other researchers believe that the identification and treatment of precancerous pancreatic lesions offers a promising strategy to reduce the number of people losing their lives to this disease.

Similar to how colon polyps can progress into colon cancer, we now know that certain types of pancreatic cystic lesions can progress into pancreatic cancer. Pancreatic cancer precursors/pre-cancers known as intraductal papillary mucinous neoplasms (IPMNs) account for nearly one-half of the estimated 150,000 asymptomatic pancreatic cysts detected as ‘incidental findings’ on computed tomography (CT) scans or magnetic resonance imaging (MRI) scans each year during the clinical work-up for an unrelated condition.  Imaging alone cannot reliably distinguish between benign, pre-cancerous, and cancerous cysts, and cannot differentiate ‘low-risk’intraductal papillary mucinous neoplasms‘ (defined as low- or moderate-grade disease) that can be monitored from ‘high-risk’ IPMNs (defined as high-grade or invasive disease) that should be surgically removed.  The decision to undergo pancreatic surgery is not trivial for the patient and medical team since pancreatic surgery can be associated with an estimated 40% chance of complications and a 4% chance of death. Noninvasive tests are needed to accurately detect precancerous lesions of the pancreas so that personalized risk assessment and care can be provided.

microRNAs (miRNAs) are small molecules that act as ‘master-regulators’ of cancer-related processes in the body. One of the main purposes of our ‘proof of principle’ study was to measure miRNAs in the blood and determine whether a set of miRNAs could distinguish patients with IPMNs from healthy individuals. We then sought to determine whether a set of miRNAs could distinguish patients known to have ‘low-risk’ IPMNs from those with ‘high-risk’ IPMNs.  We show that new, relatively inexpensive digital technology could reliably measure miRNAs in blood plasma (the pale yellow liquid component of blood) from individuals newly-diagnosed with pancreatic cancer precursors (IPMNs) and healthy individuals.  Thirty miRNAs out of 800 tested showed higher levels in IPMN patients compared to healthy individuals, providing a preliminary ‘miRNA signature’ that may be found only in people with early pancreatic disease, suggesting it could serve as an early diagnostic tool.  Furthermore, we also provide preliminary data to suggest that a 5-miRNA signature can partially distinguish high-risk IPMNs that warrant resection from low-risk IPMNs that can be watched.  This is important clinically because it would be opportune to personalize care such that high-risk IPMNs that warrant resection are properly identified while individuals with low-risk IPMNs are spared the substantial  risks of mortality and morbidity associated with overtreatment from unnecessary surgery.

Medical Research: What should clinicians and patients take away from your report?

Dr. Wey: This is promising news and could someday lead to a noninvasive test for early detection of this disease.  This could translate into earlier diagnoses and lives saved. However, It is important to note that the results presented in this study are preliminary.  Additional research is needed to determine if such a miRNA-based blood test could help diagnose pancreatic cancer earlier or more effectively than current methods.  These results need to be verified in a larger prospective, or forward-looking, study before being available for use in the clinical setting.  This could take several years and will involve pancreatic cancer researchers working together with patients and families affected by this disease.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Wey: Findings from this proof of principle study support further development of a miRNA-based blood test to detect precancerous lesions in the pancreas.  Large-scale studies with rigorous designs are needed to further explore the potential for miRNAs to be utilized clinically as markers for the early detection of pancreatic cancer.Through recently-obtained funding from the State of Florida and the newly established Florida Academic Cancer Center Alliance, our team at Moffitt Cancer Center plans to further our research on IPMNs by partnering with researchers from the University of Florida Health Cancer Center and the University of Miami/Sylvester Comprehensive Cancer Center. This new partnership, called the Florida Pancreas Collaborative, representsthe first state-wide multi-cancer center collaboration we are aware of that is dedicated to conducting research on IPMNs with the ultimate goal of promoting the prevention and early detection of pancreatic cancer.

 

 Citation:

“Plasma MicroRNAs as Novel Biomarkers for Patients with Intraductal Papillary Mucinous Neoplasms of the Pancreas.” Cancer Prev Res Published OnlineFirst August 27, 2015; DOI: 10.1158/1940-6207.CAPR-15-0094

 

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Jenny Permuth Wey, PhD, MS (2015). miRNA-based Blood Test May Detect Early Pancreatic Cancer MedicalResearch.com

Last Updated on August 28, 2015 by Marie Benz MD FAAD