Journal Article

Combined circulating tumor DNA and protein biomarker-based liquid biopsy for the earlier detection of pancreatic cancers

Brand, Randall E., Allen, Peter J., Doglioni, Claudio, Tie, Jeanne, Petersen, Gloria M., Thoburn, Christopher, Hruban, Ralph H., Falconi, Massimo, Singhi, Aatur D., Makary, Martin A., Tomasetti, Cristian, Weiss, Matthew J., Schaefer, Joy, Ptak, Janine, Papadopoulos, Nickolas, Kim, Song Cheol, Popoli, Maria, Maitra, Anirban, Klein, Alison P., Wang, Yuxuan, Javed, Ammar A., Dobbyn, Lisa, Lennon, Anne Marie, Wolfgang, Christopher L., Ahuja, Nita, Goggins, Michael G., Yip-Schneider, Michele T., Silliman, Natalie, Wong, Fay, Schmidt, C. Max, Gibbs, Peter, He, Jin, Vogelstein, Bert, Schattner, Mark, Cohen, Joshua D., Kinzler, Kenneth W., Hong, Seung-Mo, Li, Lu, Hanash, Samir M., Molin, Marco Dal

2017

Overview

The earlier diagnosis of cancer is one of the keys to reducing cancer deaths in the future. Here we describe our efforts to develop a noninvasive blood test for the detection of pancreatic ductal adenocarcinoma. We combined blood tests for KRAS gene mutations with carefully thresholded protein biomarkers to determine whether the combination of these markers was superior to any single marker. The cohort tested included 221 patients with resectable pancreatic ductal adenocarcinomas and 182 control patients without known cancer. KRAS mutations were detected in the plasma of 66 patients (30%), and every mutation found in the plasma was identical to that subsequently found in the patient’s primary tumor (100% concordance). The use of KRAS in conjunction with four thresholded protein biomarkers increased the sensitivity to 64%. Only one of the 182 plasma samples from the control cohort was positive for any of the DNA or protein biomarkers (99.5% specificity). This combinatorial approach may prove useful for the earlier detection of many cancer types.

• Publisher: National Academy of Sciences
• Subject: Adenocarcinoma / Aged / Biological Sciences / Biomarkers / Biopsy / Blood / Blood tests / CA-19-9 Antigen - blood / Cancer / Carcinoma, Pancreatic Ductal - blood / Carcinoma, Pancreatic Ductal - diagnosis / Carcinoma, Pancreatic Ductal - genetics / Case-Control Studies / Circulating Tumor DNA - blood / Combinatorial analysis / Deoxyribonucleic acid / DNA / Female / Genes, p53 / Humans / K-Ras protein / Liquid Biopsy / Male / Medical Sciences / Middle Aged / Mutation / Pancreas / Pancreatic cancer / Pancreatic Neoplasms - blood / Pancreatic Neoplasms - diagnosis / Pancreatic Neoplasms - genetics / Patients / Plasmas (physics) / Proto-Oncogene Proteins p21(ras) - genetics / Studies / Tumors