Review of clinical and emerging biomarkers for early diagnosis and treatment management of pancreatic cancer: towards personalised medicine

2021 ◽  
pp. 1-13
Author(s):  
Ernest Osei ◽  
Christabel Oghinan ◽  
Akua Asare ◽  
Hillary Ho ◽  
Solomon Manful
Keyword(s):  
Pancreatic Cancer ◽  
High Risk ◽  
Early Detection ◽  
Early Diagnosis ◽  
Specific Treatment ◽  
High Specificity ◽  
Patient Specific ◽  
Patient Response ◽  
Clinical Biomarkers ◽  
Specificity And Sensitivity

Abstract Background: Pancreatic cancer is the 12th most commonly diagnosed cancer and the 3rd leading cause of cancer mortality and accounts for approximately 2·7% of all newly diagnosed cancer cases and 6·4% of all cancer mortalities in Canada. It has a very poor survival rate mainly due to the difficulty of detecting the disease at an early stage. Consequently, in the advancement of disease management towards the concept of precision medicine that takes individual patient variabilities into account, several investigators have focused on the identification of effective clinical biomarkers with high specificity and sensitivity, capable of early diagnosis of symptomatic patients and early detection of the disease in asymptomatic individuals at high risk for developing pancreatic cancer. Materials and methods: We searched several databases from August to December 2020 for relevant studies published in English between 2000 and 2020 and reporting on biomarkers for the management of pancreatic cancer. In this narrative review paper, we describe 13 clinical and emerging biomarkers for pancreatic cancers used in screening for early detection and diagnosis, to identify patients’ risk for metastatic disease and subsequent relapse, to monitor patient response to specific treatment and to provide clinicians the possibility of prospectively identifying groups of patients who will benefit from a particular treatment. Conclusions: Current and emerging biomarkers for pancreatic cancer with high specificity and sensitivity has the potential to account for individual patient variabilities, for early detection of disease before the onset of metastasis to improve treatment outcome and patients’ survival, help screen high-risk populations, predict prognosis, provide accurate information of patient response to specific treatment and improve patients monitoring during treatment. Thus, the future holds promise for the use of effective clinical biomarkers or a panel of biomarkers for personalised patient-specific targeted medicine for pancreatic cancer.

scholarly journals Developing of a Simple Screening Tool for Opportunistic COPD Case Finding

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
Y M Mohamed ◽  
S H Sharkawy ◽  
D I Darwish
Keyword(s):  
High Risk ◽  
Early Detection ◽  
Early Diagnosis ◽  
Outpatient Clinic ◽  
World Wide ◽  
Screening Tool ◽  
Case Finding ◽  
Screening Questionnaire ◽  
Risk Patients ◽  
Simple Screening

Abstract Background Under diagnosis of COPD is serious problem in many countries world-wide because there are no generally detection tools available to detect high-risk patients for spirometry, and patients will not go for COPD check-up until a serious issue happens like exacerbation. Objective The aim of the work is trying to assess a new screening tool for early diagnosis of COPD. Patients and Methods The present study was conducted upon 500 subjects during the period from march 2018 to august 2018 who admitted to our chest department or visit our outpatient clinic, employees and visitors to Ain Sham hospitals.All subjects >40yrs who smoker or ex-smoker(≥10pack-years) applied a six variants(age,sex,packed years smoked during life ,dyspnea,chronic phlegmand chronic cohgh)questionnaire modified from PUMA questionnaire Subjects with score ≥5 did spirometry Results 500 subjects shared in the study 497 of them were males ( 99.4% )and 3 were females (.6%). 152of them(30.4%) had score <5 and 348 of them (69.6%)had score ≥5 who did spirometry.152 subjects did not perform spirometry. By spirometry we diagnosed 81(23.3) case COPD (fev1-fvc <.7) out of 348 subjects under gone spirometry and 16.2% of total subjects(500) . Conclusion Modified puma score is a simple and easy screening questionnaire for early detection of COPD cases and spirometry should be done to confirm the diagnosis or rule out.COPD is prevalent in many healthy apparent persons.

A review of clinical and emerging biomarkers for breast cancers: towards precision medicine for patients

2020 ◽  
pp. 1-14
Author(s):  
Ernest Osei
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Precision Medicine ◽  
Specific Treatment ◽  
Cancer Biomarkers ◽  
Targeted Treatment ◽  
Patient Specific ◽  
Breast Cancers ◽  
Breast Cancer Biomarkers ◽  
Clinical Breast

Abstract Background: Breast cancer is the most commonly diagnosed malignancy among women and accounts for about 25% of all new cancer cases and 13% of all cancer deaths in Canadian women. It is a highly heterogeneous disease, encompassing multiple tumour entities, each characterised by distinct morphology, behaviour and clinical implications. Moreover, different breast tumour subtypes have different risk factors, clinical presentation, histopathological features, outcome and response to systemic therapies. Therefore, any strategies capable of the stratification of breast cancer by clinically relevant subtypes are an important requirement for personalised and targeted treatment. Therefore, in the advancement towards the concept of precision medicine that takes individual patient variability into account, several investigators have focused on the identification of effective clinical breast cancer biomarkers that interrogate key aberrant pathways potentially targetable with molecular targeted or immunological therapies. Methods and materials: This paper reports on a review of 11 current clinical and emerging biomarkers used in screening for early detection and diagnosis, to stratify patients by disease subtype, to identify patients’ risk for metastatic disease and subsequent relapse, to monitor patient response to specific treatment and to provide clinicians the possibility of prospectively identifying groups of patients who will benefit from a particular treatment. Conclusion: The future holds promising for the use of effective clinical breast cancer biomarkers for early detection and personalised patient-specific targeted treatment and increased patient survival. Breast cancer biomarkers can potentially assist in early-staged, non-invasive, sensitive and specific breast cancer detection and screening, provide clinically useful information for identification of patients with a greater likelihood of benefiting from the specific treatment, offer a better understanding of the metastatic process in cancer patients, predict disease and for patients with the established disease can assist define the nature of the disease, monitor the success of treatment and guide the clinical management of the disease.

Interim results of a screening protocol for early detection of pancreatic cancer in asymptomatic high-risk patients.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 223-223
Author(s):  
Alexandra Gangi ◽  
Mokenge Peter Malafa ◽  
Jason Klapman
Keyword(s):  
Pancreatic Cancer ◽  
Clinical Trial ◽  
High Risk ◽  
Early Detection ◽  
Surgical Resection ◽  
Early Stage ◽  
Needle Aspiration ◽  
Screening Protocol ◽  
Risk Patients ◽  
Asymptomatic Individuals

223 Background: Pancreatic cancer (PC) is the 4th leading cause of cancer deaths in the US but is rarely diagnosed at an early curable stage. Early detection of PC will have measurable improved outcomes in affected patients. This study sets out to evaluate if EUS can detect early stage pre-cancerous or cancerous changes in the pancreas of high risk (HR) patients. Methods: After IRB review, a clinical trial (NCT01662609) to evaluate HR patients was opened to accrual. Study subjects met specified inclusion and exclusion criteria as defined by the protocol. Enrolled subjects underwent EUS followed by screening as defined by study protocol: subjects with normal EUS underwent repeat EUS at 1 year; subjects with abnormal EUS underwent fine needle aspiration (FNA) if a mass or cyst was found and measured ≥ 5mm and did not undergo FNA if the lesion measured < 5mm. Those with indeterminate or benign FNA underwent pancreatic CT scan with repeat EUS/FNA at 3 or 6 months respectively. Those with positive FNA were treated appropriately based on findings. Patients with mass/cyst < 5mm underwent repeat EUS/FNA at 3 months. Targeted follow-up is 5 years. Results: Of the 52 subjects accrued thus far, 41 were available for interim analysis. Twenty-seven (67%) subjects had a normal EUS while 14 (34%) subjects had abnormal findings. Two patients had large cysts with FNA consistent with an intraductal papillary mucinous neoplasms (IPMN). These 2 subjects ultimately underwent surgical resection. The 12 remaining subjects had at least 1 subcentimeter lesion and are being routinely screened per the outlined protocol. Conclusions: EUS screening of asymptomatic individuals who are at high risk for pancreatic cancer as defined by our inclusion criteria frequently detects abnormal lesions in the pancreas. These lesions include high risk IPMNs that warrant surgical resection. Our results validate the results of other high risk screening protocols and support the screening of individuals who are at high risk for development of pancreatic cancer. Clinical trial information: NCT01662609.

The Spanish national familial pancreatic cancer registry Pan-Gen-FAM: Screening of high-risk individuals for the early detection of a pancreatic tumor

Pancreatology ◽  
2016 ◽  
Vol 16 (3) ◽  
pp. S87
Author(s):  
Carmen Guillén-Ponce ◽  
Reyes Ferreiro ◽  
Vanessa Pachon ◽  
Julie Earl ◽  
Maria Teresa Salazar Lopez ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
High Risk ◽  
Early Detection ◽  
Cancer Registry ◽  
Pancreatic Tumor ◽  
Familial Pancreatic Cancer

scholarly journals miRNAs as biomarkers of high-risk pancreatic cysts: a possible holy grail for the early detection of pancreatic cancer

2015 ◽  
Vol 11 (23) ◽  
pp. 3105-3108
Author(s):  
Jennifer B Permuth ◽  
Christina Georgeades ◽  
Mokenge Malafa
Keyword(s):  
Pancreatic Cancer ◽  
High Risk ◽  
Early Detection ◽  
Pancreatic Cysts ◽  
Holy Grail

scholarly journals Novel clinical biomarkers in blood and pleural effusion for diagnosing patients with tuberculosis distinguishing from malignant tumor

2021 ◽  
Author(s):  
Jian Wang ◽  
Zhe-Xiang Feng ◽  
Tao Ren ◽  
Wei-Yu Meng ◽  
Imran Khan ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Malignant Tumor ◽  
Malignant Tumors ◽  
High Specificity ◽  
Diagnostic Value ◽  
Blood Parameters ◽  
Clinical Indicators ◽  
Clinical Biomarkers ◽  
Specificity And Sensitivity ◽  
Single Marker

Abstract Background Pleural effusion (PE) is a common manifestation of tuberculosis and malignant tumors, but it is difficult to distinguish tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE), especially by non-invasive detection indicators. We aimed to find effective detection indexes in blood and PE for differentiating patients with tuberculosis from a malignant tumor. Methods 815 patients were collected who diagnosed with tuberculosis or cancer at Taihe hospital from 2014 to 2017. 717 patients were found to have PE by thoracoscopy. The clinical characteristics, patients’ blood parameters, and PE indicators information were summarized for analysis. Results The patients with MPE had higher percentages to be bloody and negative of Rivalta test in PE than patients with TPE. Then for clinical indicators, comparing specific parameters in blood, we observed 18 indicators were higher in the TPE group than in the MPE group. On contrast, 12 indicators were higher in the MPE group than in the TPE group (p < 0.01). In addition, in PE tests, we found there were 3 parameters higher in TPE and other 4 parameters higher in MPE patients group (p < 0.01). Then for clinical diagnosing practice, ROC and PCA analysis were applied. Top six relevant indicators with AUC value over 0.70 were screened out: pADA (0.90), pHsCRP (0.79), sMONp (0.75), sHsCRP (0.73), sESR (0.71), and sD-dimer (0.70). Moreover, with the Logistic regression model, a specific combination of 3 biomarkers pADA, sMONp, and sHsCRP could enhance distinguishing tuberculosis from malignant tumor patients with PE (AUC=0.944, 95% CI=0.925-0.964). For the top single marker pADA, we further analyzed its diagnostic function in patients with different group and observed it kept the high specificity and sensitivity. Conclusions The six indicators of pADA, pHsCRP, sMONp, sHsCRP, sESR and sD-dimer showed significant diagnostic value for clinicians. Further, the combination of pADA, sMONp, and sHsCRP has high accuracy for differential diagnosis for the first time. Mostly interestingly, pADA single marker maintained high specificity and sensitivity in patients with different status, which has great value for the rapid and accurate diagnosis of suspected cases.

185 DISCOVERY OF A SERUM N-GLYCAN PANEL FOR EARLY DETECTION OF PANCREATIC CANCER IN A HIGH-RISK SURVEILLANCE COHORT

2021 ◽  
Vol 160 (6) ◽  
pp. S-45-S-46
Author(s):  
Iris J. Levink ◽  
Derk C.F. Klatte ◽  
R.G. Hanna-Sawires ◽  
Yuri E.M. van der Burgt ◽  
Kasper A. Overbeek ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
High Risk ◽  
Early Detection

scholarly journals 4107 Implementation and evaluation of a novel protocol that uses clinical biomarkers to promote early diagnosis and treatment of Neurodevelopmental Disabilities

2020 ◽  
Vol 4 (s1) ◽  
pp. 72-73
Author(s):  
Tara Lynn Johnson ◽  
Sowmya Sivakumar ◽  
Namarta Kapil ◽  
Bittu Majmudar
Keyword(s):  
Early Intervention ◽  
High Risk ◽  
Early Diagnosis ◽  
Clinical Care ◽  
Standard Of Care ◽  
Early Intervention Services ◽  
Neurodevelopmental Disabilities ◽  
Clinical Biomarkers ◽  
High Risk Infants ◽  
New Biomarkers

OBJECTIVES/GOALS: Our objective was to establish a new protocol to evaluate new biomarkers to detect Neurodevelopmental Disabilities (NDD) in high-risk infants. As early intervention results in better outcomes, our goal was to implement the protocol to promote earlier NDD diagnosis and referral for treatment. METHODS/STUDY POPULATION: We implemented a new protocol using the General Movement Assessment (GMA), Hammersmith Infant Neurological Examination (HINE), and Capute Scales to evaluate infants who were at high risk of NDD. To determine the success of our protocol with these biomarkers, we studied former premature infants who were evaluated in follow-up clinic from 10/1/2018-10/1/2019. We defined our primary and secondary outcomes as the ages of neurodevelopmental diagnoses and referral to early intervention services before and after implementation of the new protocol, respectively. Our hypotheses were that infants who were evaluated with these biomarkers would be diagnosed with NDD and be referred for treatment at younger ages than their counterparts. RESULTS/ANTICIPATED RESULTS: Approximately 120 patients were evaluated during the time period that was defined. About half were evaluated prior to implementing the GMA and HINE, and the remainder were evaluated using GMA and other developmental measures. We anticipate that infants who underwent GMA will be diagnosed with NDD and referred for therapies at a younger age than their counterparts. DISCUSSION/SIGNIFICANCE OF IMPACT: Through our translational research, we will transform the standard of care for high-risk infants by incorporating clinical biomarkers into day-to-day clinical care for these infants. Implementation of this novel protocol will promote the early diagnosis and referral to treatment for NDD.

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