News & Commentary

Urine Test Seems to Spot Pancreatic Cancer Earlier

One of the reasons pancreatic cancer is so deadly is because it sidesteps early detection. “Despite considerable progress in our understanding of the disease at the molecular level, novel findings have not yet translated into clinical benefits and the majority of patients are still faced with a grim median survival of 5 to 6 months,” states a study in the August 1 issue of Clinical Cancer Research that provides hope for early detection.

Researchers at Barts Cancer Institute of Queen Mary University of London say that they have discovered a novel, three-protein biomarker panel that might be able to detect patients with early-stage pancreatic cancer using urine specimens. It’s an early study, though, and clinical application of the assay, if it ever happens, is years away.

Urine as a source of biomarkers for cancer has advantages over blood. It is far less complex and can be sampled repeatedly and noninvasively. What’s more, as the authors point out, urine is an “ultrafiltrate” of blood, so some biomarkers might be found in higher concentrations.

For this study, the researchers initially analyzed six urine samples (three males and three females) from healthy patients with chronic pancreatitis and pancreatic cancer patients—18 samples in total—and found about 1,500 proteins. They ended up zeroing in on three: LYVE1, REG1A, and TFF1.

Tatjana Crnogorac-Jurcevic, the senior author, says those three were selected based on both “their functional roles as well as the statistical difference when compared to the experimental groups.”

They looked for the three proteins in urine samples from 87 healthy people, 92 patients with chronic pancreatitis, and 192 with pancreatic cancer patients. The combination identified early stage pancreatic cancer with 90% accuracy.

“To our knowledge, a panel with such performance has not been reported as yet,” the study states, “although this will need to be confirmed in a larger, independent study.”

Currently, the diagnosis of pancreatic cancer is usually made by contrast-enhanced CT after late symptoms such as jaundice and weight loss have already appeared.

“Such procedures are expensive and involve radiation; novel, highly accurate and noninvasive diagnostic tests would thus fill a major clinical need for screening high-risk populations and patients with suggestive symptoms,” says Crnogorac-Jurcevic.

However, the road to this experimental test actually being used is long and barriers, high. Crnogorac-Jurcevic and her colleagues have already hit a stumbling block.

“Despite a proof of principle study where we showed that signatures of this malignancy can be found in urine, we were still unable to secure the funding to continue work for several years,” Crnogorac-Jurcevic tells Managed Care.

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