Evaluating the heavy/light chain immunoglobulin biomarker for early relapse detection in multiple myeloma: A comparative study with conventional methods

Simple SummaryDetecting cancer early significantly increases the chances of successful (surgical) treatment. Pancreatic cancer is one of the deadliest cancer forms, since it is usually discovered at a late and already spread stage. Finding biomarkers showing pancreatic cancer at an early stage is a possible approach to early detection and improved treatment. The aim of our study was to assess the potential of tissue polypeptide specific antigen (TPS) as a biomarker for early pancreatic cancer detection. We studied TPS levels in blood plasma samples from a population-based biobank in Västerbotten, Sweden that were collected before individuals were diagnosed with pancreatic cancer. Although TPS levels are raised at diagnosis, this occurs late, and thus TPS does not seem to hold promise as an early detection marker for pancreatic cancer.Early detection of pancreatic ductal adenocarcinoma (PDAC) is challenging, and late diagnosis partly explains the low 5-year survival. Novel and sensitive biomarkers are needed to enable early PDAC detection and improve patient outcomes. Tissue polypeptide specific antigen (TPS) has been studied as a biomarker in PDAC diagnostics, and it has previously been shown to reflect clinical status better than the ‘golden standard’ biomarker carbohydrate antigen 19-9 (CA 19-9) that is most widely used in the clinical setting. In this cross-sectional case-control study using pre-diagnostic plasma samples, we aim to evaluate the potential of TPS as a biomarker for early PDAC detection. Furthermore, in a subset of individuals with multiple samples available at different time points before diagnosis, a longitudinal analysis was used. We assessed plasma TPS levels using enzyme-linked immunosorbent assay (ELISA) in 267 pre-diagnostic PDAC plasma samples taken up to 18.8 years before clinical PDAC diagnosis and in 320 matched healthy controls. TPS levels were also assessed in 25 samples at PDAC diagnosis. Circulating TPS levels were low both in pre-diagnostic samples of future PDAC patients and in healthy controls, whereas TPS levels at PDAC diagnosis were significantly increased (odds ratio 1.03; 95% confidence interval: 1.01–1.05) in a logistic regression model adjusted for age. In conclusion, TPS levels increase late in PDAC progression and hold no potential as a biomarker for early detection.

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive cancer with a poor prognosis, primarily due to a late diagnosis. Recent studies have focused on identifying non-invasive biomarkers for early detection, with microRNAs (miRNAs) emerging as promising candidates. This systematic review aims to evaluate the potential of circulating miRNAs as biomarkers for the early detection of PDAC, analyzing their diagnostic accuracy, specificity, and sensitivity. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search across PubMed, Embase, and the Cochrane Library was conducted. Studies published from January 2013 to October 2023 focusing on miRNA biomarkers for early PDAC detection were included. Data synthesis was performed through a narrative approach due to the heterogeneity of the studies. Nine studies met the inclusion criteria. Key findings include the elevated levels of specific miRNAs, such as miR-18a, miR-106a, and miR-25, in early-stage PDAC patients compared to controls. The integration of miRNA profiles with traditional biomarkers like CA19-9 showed improved diagnostic performance. However, challenges in the standardization of miRNA evaluation methodologies were noted. Circulating miRNAs demonstrate significant potential as non-invasive biomarkers for early PDAC detection. Despite promising results, further research and standardization are necessary for clinical application.

Pancreatic cancer is one of the most fatal human cancers, with an overall 5-year survival rate of 10.8%. Early detection is critical for improving pancreatic cancer prognosis, but biomarkers for early detection are lacking. We conducted a two-stage study to identify circulating miRNAs as biomarkers for pancreatic cancer early detection using pre-diagnostic plasma samples, collected within 5 years prior to cancer diagnosis, from case-control studies nested in five prospective studies. The discovery stage included 185 case-control pairs from the Prostate, Lung, Colorectal and Ovarian Cancer (PLCO) Screening Trial. Replication stage samples comprised 277 case-control pairs from diverse cohorts: Shanghai Women’s and Men’s Health Studies, Southern Community Cohort Study (SCCS), and Multiethnic Cohort. Controls were individually matched on age at enrollment, sex, recruitment site (SCCS), race/ethnicity, and date of blood draw in each cohort. Cell-free small RNAs were extracted from plasma samples and miRNAs were measured by the NanoString nCounter Analysis System using the Human v3 miRNA Expression panel (a total of 798 miRNAs). Normalized miRNAs were categorized by decile. For miRNAs that have ≥10% samples with an undetectable level (0), the non-zero level was categorized by approximately 10% increment. Associations of circulating miRNAs with pancreatic cancer risk, measured in odds ratios (ORs) and 95% confidence intervals (CIs) per decile change, were calculated using conditional logistic regression analyses in discovery and replication studies, separately within each cohort, and results meta-analyzed. We identified three miRNAs, hsa-miR-199a-3p+/hsa-miR-199b-3p, hsa-miR-191-5p, hsa-miR-767-5p, being consistently associated with pancreatic risk in both discovery and replication sets, with combined ORs (95% CIs) of 0.89 (0.84-0.95), 0.90 (0.85-0.95), and 1.08 (1.02-1.13), and P of 9.09E-05, 6.95E-05 and 4.03E-03, respectively. Adjustment for age, BMI, smoking, diabetes and family history of pancreatic cancer did not change the associations. Stratified analyses by age at diagnosis found five additional replicated miRNAs: hsa-miR-640, hsa-miR-1299, hsa-miR-22-3p, hsa-miR-874-5p, and hsa-miR-449b-5p among those 65 years or older, with combined ORs (95% CIs) of 1.33 (1.16-1.52), 1.28 (1.12-1.46), 0.76 (0.65-0.89), 1.25 (1.09-1.43), and 1.22 (1.07-1.39), and P-value ranging from 4.75E-05 to 0.003. These results suggest that circulating miRNA biomarkers may be useful in identifying individuals with high risk of developing pancreatic cancer for close surveillance and/or a screening test. Citation Format: Cong Wang, Hui Cai, Qiuyin Cai, Jie Wu, Rachael Stolzenberg-Solomon, Clair Zhu, Yu-Tang Gao, Jordan Berlin, Fei Ye, Wei Zheng, Veronica W. Setiawan, Xiao-Ou Shu. Circulating miRNA as biomarkers for pancreatic cancer early detection [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr LB109.

International Liver Cancer Association (ILCA) White Paper on Biomarker Development for Hepatocellular Carcinoma

Methods and biomarkers for early detection, prediction, and diagnosis of colorectal cancer

Visualization of Bortezomib Induced Peripheral Neuropathy By Dorsal Root Ganglion MRI in Patients with Multiple Myeloma

Circulating tumor DNA as an early cancer detection tool.

IA16: Current and emerging molecular diagnostic assays for colorectal cancer

e20554 Background: Our laboratory previously demonstrated that heparanase (HPSE), an enzyme that cleaves heparan sulfate, upregulates growth factors and their receptors, resulting in enhanced multiple myeloma (MM) growth, chemoresistance, and metastasis. Targeting HPSE therapeutically decreases chemoresistance and relapse. Renal dysfunction is a major problem in MM patients with nearly 50% having renal dysfunction at diagnosis of which 19% are advanced, and 8% require dialysis. There is no specific therapy for myeloma associated renal dysfunction highlighting the need to identify novel mechanisms that lead to the development of targeted therapies. This is the first study to investigate the association between HPSE activity and renal dysfunction in MM patients by utilizing high-sensitivity biomarkers. Methods: Human Kidney 2 (HK-2) cells were treated with HPSE. Necrosis and apoptosis were assessed by flow cytometry. Cell lysates were examined for expression of kidney injury biomarkers by western blotting. HK-2 clusters were co-cultured with MM-spheroids with low or high HPSE. SCID mice were injected with 3 million luciferase-positive myeloma cells with low or high level of HPSE. Kidneys were harvested after 3 weeks and processed for studies. HPSE activity and biomarkers using multiplex magnetic bead ELISA were assessed in peripheral blood from a MM patient with serum creatinine 1.2 mg/dL and a healthy control donor. Results: HPSE induced HK-2 cell necrosis and apoptosis. HPSE induced significant expression by HK-2 cells of KIM-1, NGAL and IGFBP-7. Co-culturing HK-2 organoids with MM-spheroids expressing high HPSE compromised HK-2 organoids survival over 7 days. Damage to HK-2 cells was prevented by HPSE inhibitors Roneparstat or OGT-2115. Kidney tissues from mice harboring HPSE-high myeloma tumors expressed more KIM-1 and NGAL than those harboring HPSE-low myeloma tumors. HPSE activity was 6-fold higher and kidney injury biomarkers were many fold (range 2 – 84) higher in the plasma of a MM patient than in plasma from healthy control. Conclusions: HPSE causes kidney cellular injury which can be detected early by the measurement of high sensitivity biomarkers and can be prevented by treatment with HPSE inhibitors, Roneparstat and OGT-2115. Further studies are ongoing to investigate the association between HPSE activity and renal dysfunction in a larger cohort of MM patients which have been accrued as a part of the UAB-Integrative Molecular And Genetic Epidemiology (IMAGE) Study of Myeloma.

DETECT: Development of Technologies for Early HCC Detection

Genome-Wide Identification and Validation of a Novel Methylation Biomarker, SDC2, for Blood-Based Detection of Colorectal Cancer

Lung cancer remains the leading cause of cancer-related mortality worldwide, largely due to its asymptomatic nature in early stages and consequent late diagnosis. The development of reliable, non-invasive biomarkers for early detection is critical to improving prognosis and survival rates. Recent advances in omics technologies and liquid biopsy have led to the identification of novel biomarkers, including circulating tumor DNA (ctDNA), microRNAs (miRNAs), exosomes, and protein signatures. These biomarkers show promise in enhancing diagnostic accuracy, risk stratification, and monitoring of disease progression. This review highlights the current landscape of emerging biomarkers for early lung cancer detection, evaluates their clinical utility, and discusses the challenges in their translation to routine clinical practice. Integration of these biomarkers with imaging and artificial intelligence-based diagnostic tools may offer a transformative approach for early lung cancer diagnosis.

GPC-3 in hepatocellular carcinoma; A novel biomarker and molecular target.

BackgroundAmyloid‐ß (Aß) accumulation in brain is an early hallmark of Alzheimer’s disease (AD). We discovered Aß deposition, ß‐amyloidopathy, and colocalizing supranuclear cataracts (SNC) in lenses from people with AD (Goldstein LE et al., Lancet, 2003) and Down syndrome (DS; Moncaster JA et al., PLoS One, 2010), but not other neurodegenerative diseases or normal aging. These findings spurred development of an investigational drug‐device lens Aß eye scanner (Sapphire II, Cognoptix) that combines an Aß‐binding fluorescent ligand (Aftobetin) and specialized laser scanning ophthalmoscope for noninvasive measurement of lens Aß (FDA Breakthrough Device, 2021). Early clinical results indicate that lens Aß is an ideal biomarker for early AD detection. Here, we investigated Aß accumulation and amyloidopathy in lens and brain.MethodTg2576 transgenic (Tg+) mice express Swedish mutant human amyloid precursor protein (hAPP‐Swe), human Aß (hAß), ß‐amyloidopathy, and cognitive deficits (Hsiao et al., Science, 1996). Non‐transgenic (Tg–) littermates were used as controls. Lenses were examined by ex vivo lens stereomicroscopy. Brains and lenses were analyzed by Aß immunohistochemistry, amyloid histopathology, anti‐Aß immunogold electron microscopy, tryptic digest mass spectrometry, anti‐hAß ELISA/immunoblotting. Quasi‐elastic light scattering hAß‐lens protein aggregation analysis.ResultTg2576 Tg+ mice, but not Tg– controls, age‐dependently express hAPP, accumulate hAß, and develop hAß molecular pathology in the lens and exhibit age‐dependent Aß supranuclear opacification that recapitulates lens pathology and SNC phenotype expression in human AD and DS. We detected hAß in conditioned medium from Tg+ but not Tg– lens explant cultures. hAß potently promotes mouse lens protein aggregation in vitro.ConclusionThese results support mechanistic (genotype‐phenotype) linkage between age‐dependent Aß pathology and AD‐related phenotypes in lens and brain. Collectively, our findings identify Aß pathology as the shared molecular etiology of age‐dependent supranuclear cataracts associated with two human diseases (AD, DS) and homologous murine cataracts in the Tg2576 transgenic mouse model of AD. These results represent the first evidence of AD‐related Aß pathology outside the brain and support lens Aß as an optically‐accessible biomarker for early detection and longitudinal monitoring of AD.

BackgroundAmyloid‐β (Aβ) accumulation in brain is an early hallmark of Alzheimer’s disease (AD). We discovered Aβ deposition, β‐amyloidopathy, and colocalizing supranuclear cataracts (SNC) in lenses from people with AD (Goldstein LE et al., Lancet, 2003) and Down syndrome (DS; Moncaster JA et al., PLoS One, 2010), but not other neurodegenerative diseases or normal aging. These findings spurred development of an investigational drug‐device lens Aβ eye scanner (Sapphire II, Cognoptix) that combines an Aβ‐binding fluorescent ligand (Aftobetin) and specialized laser scanning ophthalmoscope for noninvasive measurement of lens Aβ (FDA Breakthrough Device, 2021). Early clinical results indicate that lens Aβ is an ideal biomarker for early AD detection. Here, we investigated Aβ accumulation and amyloidopathy in lens and brain.MethodTg2576 transgenic (Tg+) mice express Swedish mutant human amyloid precursor protein (hAPP‐Swe), human Aβ (hAβ), β‐amyloidopathy, and cognitive deficits (Hsiao et al., Science, 1996). Non‐transgenic (Tg–) littermates were used as controls. Lenses were examined by ex vivo lens stereomicroscopy. Brains and lenses were analyzed by Aβ immunohistochemistry, amyloid histopathology, anti‐Aβ immunogold electron microscopy, tryptic digest mass spectrometry, anti‐hAβ ELISA/immunoblotting. Quasi‐elastic light scattering hAβ‐lens protein aggregation analysis.ResultTg2576 Tg+ mice, but not Tg– controls, age‐dependently express hAPP, accumulate hAβ, and develop hAβ molecular pathology in the lens and exhibit age‐dependent Aβ supranuclear opacification that recapitulates lens pathology and SNC phenotype expression in human AD and DS. We detected hAβ in conditioned medium from Tg+ but not Tg– lens explant cultures. hAβ potently promotes mouse lens protein aggregation in vitro.ConclusionThese results support mechanistic (genotype‐phenotype) linkage between age‐dependent Aβ pathology and AD‐related phenotypes in lens and brain. Collectively, our findings identify Aβ pathology as the shared molecular etiology of age‐dependent supranuclear cataracts associated with two human diseases (AD, DS) and homologous murine cataracts in the Tg2576 transgenic mouse model of AD. These results represent the first evidence of AD‐related Aβ pathology outside the brain and support lens Aβ as an optically‐accessible biomarker for early detection and longitudinal monitoring of AD.