09 Mar Pancreatic Cancer: Gut Microbiome Signature May Allow Earlier Detection
MedicalResearch.com Interview with:
Ece Kartal, PhD
Institute for Computational Biomedicine
MedicalResearch.com: What is the background for this study?
Response: Pancreatic cancer is one of the deadliest types of cancer: although incidence rates are relatively low (only few people develop pancreatic cancer in their lifetimes), it has a high lethality, with a five year survival rate of less than ~5%. Pancreatic cancer symptoms are generally unspecific so that the disease is usually detected very late which further limits therapeutic options. In light of this, earlier detection of pancreatic cancer could dramatically improve prognosis, but there are currently no affordable and non-invasive tests available in the clinic.
For pancreatic ductal adenocarcinoma (PDAC),the most common form of pancreatic cancer, it was previously found that the oral, gut and pancreatic microbiome are risk factors and may affect prognosis .
MedicalResearch.com: What are the main findings?
Response: Our key finding is that pancreatic ductal adenocarcinoma patients carry a characteristic signature set of gut microbes. We trained machine learning models that can distinguish patients from clinically matched PDAC-free controls with high accuracy based on the stool microbiome samples, even at earlier disease stages. Moreover, we found that this microbial signature is very specific for PDAC: it distinguishes PDAC patients from risk groups who have not (yet) developed a tumor, such as pancreatitis or type-2 diabetes patients, and also from other cancers such as colorectal and breast cancers.
After combining our model with Ca19-9, a marker used in clinics to monitor PDAC progression, we validated its specificity on one German PDAC cohort, plus 25 independent population studies (5,792) across 18 countries and 9 disease types.
Additionally, we traced these microbes between saliva, healthy pancreatic tissue and tumors which indicates that they may also play a role in the disease’s development or progression.
MedicalResearch.com: What should readers take away from your report?
Response: Stool-based detection of pancreatic ductal adenocarcinoma may provide a non-invasive, cost-effective and robust approach to PDAC screening in the future. Understanding the interactions between microbiome and pancreatic cancer will moreover suggest novel therapeutic avenues in the future. However, there is still much to learn about how our gut microbial communities are linked to pancreatic cancer.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Here, we propose to use gut microbiome composition to distinguish pancreatic ductal adenocarcinoma patients from healthy controls and other diseases including PDAC risk factors. This may be further developed into a non-invasive, accurate and affordable PDAC screening test in clinics in near future. Yet the link between microbes and pancreatic cancer require further investigation. Exploring the role of the microbiome in PDAC progression, survival and treatment response may provide novel insights into the disease etiology. This will be an exciting and dynamic research field for years to come, as much remains to be discovered and understood.
MedicalResearch.com: Is there anything else you would like to add?
Response: This work was the result of an international collaborative effort between research teams in Spain and Germany, funded by EMBL, CNIO, World Cancer Research, the European Research Council. A patent has been applied for to develop a pancreatic cancer diagnostic kit that detects these microbial genomes in stool samples in a rapid, non-invasive, and affordable way.
Kartal E, Schmidt TSB, Molina-Montes E, et al
A faecal microbiota signature with high specificity for pancreatic cancer
Gut Published Online First: 08 March 2022. doi: 10.1136/gutjnl-2021-324755
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