ABSTRACT
Introduction: Pancreatic cancer (PC) is the fourth leading cause of cancer-related death in the US with a 5-year survival rate of about 5%. Most patients have advanced metastatic disease mainly due to the lack of an effective early detection, and an extremely poor prognosis. Advancing in the fight against PC requires developing novel observable biomarkers at preclinical stages for early detection.
Areas covered: This manuscript is an overview of different PC diagnostic modalities and the latest innovations made to enhance early PC detection through the patents published from 2011 to 2017. It also comments on the ongoing clinical trials and highlights the main challenges to be addressed in the future.
Expert opinion: At present, real efforts are being made to identify new specific biomarkers with a potential clinical applicability, and to develop new devices that integrate several biomarkers in order to be more sensitive and specific for the early detection of PC. Although many biomarkers have been patented recently, they will not reach the clinic until they have been validated by clinical trials. We believe that the high-throughput screening of ‘-omic’ technologies to detect tumor-specific molecular alterations can lead to an enhanced understanding of the disease mechanisms and the discovery of new clinical diagnostic biomarkers.
Article highlights
The high rate of PC mortality is due to the lack of symptoms at the early stage of the disease and to the fact that the later symptoms are usually nonspecific and varied. Thus, it is necessary to determine new biomarkers that are present and observable at preclinical stages in ordere to be useful for early PC detection.
Screening of high-risk populations is crucial in the prevention and early detection of PC.
Neither CEA nor CA 19-9, the two tumor biomarkers most commonly used in the clinic for detecting PC, appear to be sensitive and specific enough to accurately diagnose PC early. Their main clinical application is as markers to monitor progression and response to treatment.
High-throughput screening – ‘omic’ technologies that detect tumor-specific molecular alterations, including genomics, epigenetics, non-coding RNA, microbiome and metabolomics signatures, are revolutionizing this field.
Liquid biopsy, including ctDNA, microRNAs and exosomes as a less invasive approach, seem to be the future of early PC detection, because of its remarkable advantages.
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Declaration of interest
The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.