7th Space reports on a research team led by investigators at Washington University School of Medicine, St. Louis and their breakthrough in the quest to identify biomarkers predicting which pancreatic cysts may become cancerous.
A Killer if Undetected
This horrific disease kills more than 45,000 people in America each year, mostly because the disease is detected too late. Past a certain point, it is too late for a surgery to remove and halt the spread of the cancer.
A multicenter team led by Washington University School of Medicine has made great strides in actually identifying the cysts likely to become cancerous. By studying fluid from the cysts for a biomarker (an antibody called mAb Das-1—the team has been able to identify pancreatic cysts likely to become cancerous with 95% accuracy. Currently, clinical guidelines by comparison, are 74%. The team’s study will be published online in the journal Gastroenterology. The researchers analyzed the fluid, using a test to detect the Das-1 antibody biomarker. In previous research, the biomarker had been correlated with pancreatic cysts at high risk to become cancerous. In the new study, the researchers found that the biomarker was more accurate than any current method at predicting cancer risk in these patients with pancreatic cysts.
In the new study, Das worked with collaborators from The research team collected fluid from the cysts of 169 patients who had surgery to remove the pancreatic cysts. The next step, Das explained, is to see whether the biomarker can identify pancreatic cysts likely to become cancerous before a patient undergoes surgery. A gastroenterologist, Das is using endoscopic ultrasound to distinguish patients at risk for pancreatic cancer from those whose cysts often pose no threat. While patients are under anesthesia, he inserts a flexible tube with a camera down through the mouth into the abdomen.
Koushik K. Das, MD, assistant professor of medicine in the Division of Gastroenterology at Washington University notes “Some cysts have the potential to become pancreatic cancer, so there’s the thought that we should err on the side of caution and remove the cysts.” He emphasized, “But pancreas surgery is complicated. It often requires removal of the spleen, portions of the stomach, small intestine and bile duct. In an ideal world, we only would do surgery on people whose pancreatic cysts are likely to develop into cancer. As it is, we probably don’t operate on some people who need surgery and sometimes do operate when cancer isn’t present because we’re working with imprecise information.”
“Many cysts, if not most, probably should be left alone,” Das said. “But we do that at our peril because we may miss individuals harboring cancer. If we had a better biomarker, we wouldn’t have to rely on imperfect clinical and radiographic information.”
Other research institutions involved included: Massachusetts General Hospital in Boston, Johns Hopkins School of Medicine in Baltimore, Memorial Sloan Kettering Cancer Center in New York and the Rutgers-Robert Wood Johnson Medical School in New Jersey.