Early Detection of Pancreatic Cancer in High-Risk 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.

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

Pancreatology ◽

10.1016/j.pan.2016.05.295 ◽

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

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Screening and early detection of pancreatic cancer in high risk population

World Journal of Gastroenterology ◽

10.3748/wjg.v20.i9.2358 ◽

2014 ◽

Vol 20 (9) ◽

pp. 2358 ◽

Cited By ~ 25

Author(s):

Ming-Chu Chang

Keyword(s):

Pancreatic Cancer ◽

High Risk ◽

Early Detection ◽

High Risk Population ◽

Risk Population

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

Future Oncology ◽

10.2217/fon.15.230 ◽

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

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

Gastroenterology ◽

10.1016/s0016-5085(21)00856-8 ◽

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

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

Journal of Radiotherapy in Practice ◽

10.1017/s1460396921000182 ◽

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.

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Pancreatic Cancer: A Review of Risk Factors, Diagnosis, and Treatment

Technology in Cancer Research & Treatment ◽

10.1177/1533033820962117 ◽

2020 ◽

Vol 19 ◽

pp. 153303382096211

Author(s):

ZhiYu Zhao ◽

Wei Liu

Keyword(s):

Risk Factors ◽

Pancreatic Cancer ◽

High Risk ◽

Early Detection ◽

Malignant Tumor ◽

Survival Rates ◽

Young Patients ◽

Blood Type ◽

Diagnosis And Treatment ◽

Free System

This review aims to summarize the latest knowledge on factors, diagnosis, and treatment of pancreatic cancer, and aims to promote further research on this under-studied malignant tumor. At present, we urgently need to identify high-risk patients with precancerous diseases through screening approaches, so that medical professionals and the general public may better understand prevention strategies or early detection measures. Pancreatic cancer is a highly invasive malignant tumor with a fatal risk, mainly seen in men and older adults (60-85 years old). Pancreatic cancer is now increasingly observed in young patients. Because the disease has no early symptoms and can quickly invade surrounding tissues and organs, it is one of the deadliest cancers. With a view to identify the important factors for the development of pancreatic cancer, previous studies have found that smoking, alcohol, and chronic pancreatitis are considered high-risk factors. Recent studies have shown that abnormal metabolism of human microorganisms, blood type, and glucose and lipid levels are also important factors in the development of pancreatic cancer. Identifying early diagnosis options is an important way to improve detection and survival rates of pancreatic cancer. None of the many tumor markers associated with pancreatic cancer are highly specific, which also indicates further research is required to improve the early detection rate. Future directions in terms of treatment evaluating the relationship between the microbiology-free system and immunotherapy will bring a major breakthrough and is expected to bring exciting clinical applications in improving the life-cycle of pancreatic cancer patients.

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