Pancreatic cancer is the fourth most common cause of cancer-related death in the United States and has a 5-year survival rate of only 6 percent, which is the lowest rate of all types of cancer according to the American Cancer Society. This low survival rate is partially attributed to the difficulty in detecting pancreatic cancer at an early stage. According to a new ‘proof of principle’ study, researchers hope to improve pancreatic cancer survival rates by identifying markers in the blood that can pinpoint patients with premalignant pancreatic lesions called intraductal papillary mucinous neoplasms (IPMNs).
“One promising strategy to reduce the number of people affected by pancreatic cancer is to identify and treat premalignant pancreatic lesions,” said first author Jennifer Permuth-Wey, Ph.D., M.S., assistant member in the Departments of Cancer Epidemiology and Gastrointestinal Oncology at Moffitt. “IPMNs are established precursor lesions to pancreatic cancer that account for approximately half of all asymptomatic pancreatic cysts incidentally detected by computerized tomography (CT) scans or magnetic resonance imaging (MRI) in the U.S. each year.”
IPMNs can be characterized as either low- or high-risk for the development of pancreatic cancer; however, the only way to accurately characterize the severity of IPMNs is by their surgical removal that is in itself associated with a risk of complications, such as long-term diabetes and death. Alternatively, not removing the IPMN(s) could lead to a missed opportunity to prevent high-risk lesions from developing into invasive pancreatic cancer.
Moffitt researchers want to develop a fast, cost-effective blood test that can accurately differentiate low-risk IPMNs that can be monitored from high-risk IPMNs that need to be surgically removed by studying microRNAs (miRNAs), a class of small molecules that regulate key genes involved in the development and progression of cancer. “Using new digital technology, we compared the expression patterns of miRNAs in the blood and discovered a set of 30 miRNAs that differentiated between IPMN patients and healthy volunteers. We also identified five miRNAs that could distinguish between high-risk IPMNs and low-risk IPMNs,” said senior author Mokenge Malafa, M.D, F.A.C.S., department chair and program leader for Moffitt’s Gastrointestinal Oncology Program. “We are excited about our preliminary findings, but much more research is needed before such a blood test could be made available in the clinical setting.”
“The hope is that in the not-so-distant future a miRNA-based blood test can be used in conjunction with imaging features and other factors to aid the medical team in accurately predicting disease severity of IPMNs and other pancreatic cysts at the time of diagnosis or follow-up so that more informed personalized medical management decisions can be made,” explained Permuth-Wey. Moffitt Cancer Center