Abstract
Pancreatic adenocarcinoma has a horrible prognosis, which is partly due to difficulties in diagnosing the disease in an early stage. Additional blood-born biomarkers for pancreatic adenocarcinoma are needed. Epigenetic modifications, as changes in DNA methylation, is a fundamental part of carcinogenesis. The aim of this paper is to do an update on cell-free DNA methylation as blood-based biomarkers for pancreatic adenocarcinoma. The current literature including our studies clearly indicates that cell-free DNA methylation has the potential as blood-based diagnostic and prognostic biomarkers for pancreatic adenocarcinoma. However, still no clinical applicable biomarker for pancreatic adenocarcinoma based on DNA methylation do exist. Further well-designed validation studies are needed.
Highlights
Pancreatic adenocarcinoma (PDAC) is the fourth leading cause of cancer death with a five-year survival rate less than 10% [1]
No diagnostic biomarker for PDAC based on cellfree DNA methylation has reach phase 3, which involves a retrospective longitudinal study of clinical specimens collected from cancer patients before their clinical diagnosis
Nidhi Singh and coworkers [33] found cell-free DNA hypermethylation of NPTX2 and Secreted Protein Acidic and Cysteine Rich (SPARC) to be more pronounced in stage IV PDAC
Summary
Pancreatic adenocarcinoma (PDAC) is the fourth leading cause of cancer death with a five-year survival rate less than 10% [1]. A blood-based diagnostic marker for PDAC would be ideal for screening high-risk individuals or even in patients with an intermediate risk of developing PDAC, such as patients with chronic pancreatitis, late-onset diabetes and familiar disposition to PDAC [7] Such biomarkers could serve as a supplement to existing clinical tools in the diagnostic work-up of patients suspected of PDAC. Additional prognostic biomarkers would be highly beneficial by facilitating the initial identification of patients with more aggressive tumor biology, optimize therapeutic decision making and promote individualized therapy
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