Abstract 3181: The combined use of urine and serum biomarkers in early detection strategies for pancreatic cancer

Abstract

Abstract The devastatingly high level of mortality associated with pancreatic ductal adenocarcinoma (PDAC), the fourth leading cause of cancer death in the United States, has remained virtually unchanged over the past 50 years due to an inability to effectively detect and treat the disease at an early stage. Currently used imaging techniques including CT and MRI have demonstrated an inability to distinguish benign from malignant pancreatic lesions resulting in both a low sensitivity for pancreatic cancer and a high degree of unnecessary referral for highly invasive endoscopic ultrasound (EUS). A biomarker-based test that could effectively rule out the possibility of malignancy in patients presenting with an abnormal finding by CT or MRI would greatly reduce the number of unnecessary EUS procedure and the associated risk of complication as well as lead to an optimization of resources for more effective early detection of the disease. Serum biomarkers such as CA 19-9 have been under investigation in pancreatic cancer for a number of years. Recently, the use of urine in biomarker studies has garnered considerable interest based on its ease of sampling, high stability, and relative simplicity as a testing matrix. In order to evaluate the use of urine and serum biomarkers in pancreatic cancer screening, we analyzed 77 cancer-associated biomarkers in urine obtained from 55 patients diagnosed with PDAC and 44 patients diagnosed with benign pancreatic conditions. Twenty of the most relevant biomarkers were also tested in sera obtained from the same patient cohort. Forty of the 77 urine biomarkers as well as nine of the twenty serum biomarkers were significantly altered between the benign and malignant groups. Of the twenty biomarkers measured in both urine and serum, seven were more significantly altered in urine, while seven others were more significantly altered in serum. A multivariate analysis of the results identified a four-biomarker panel comprised of both serum and urine biomarkers which could discriminate PDAC from benign disease with optimal levels of sensitivity and specificity. Our results indicate a promising role for the combined use of urine and serum biomarkers in the development of improved screening strategies for pancreatic cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3181. doi:10.1158/1538-7445.AM2011-3181