Plasma thymidine kinase activity as a prognostic biomarker in pancreatic ductal adenocarcinoma: a single-center prospective study

Abstract

Background

Pancreatic ductal adenocarcinoma (PDAC) patients might benefit from a biomarker to more precisely prognosticate their overall survival to make more informed treatment and surveillance decisions. The aim of the study was to assess the circulating biomarker Thymidine kinase (TK) activity in samples from patients with PDAC to improve prognostic precision.

Material and Methods

Using the sensitive TK activity (TKa) assay DiviTum®, serum samples from 60 PDAC patients were analyzed.

Results

Median TKa value for patients with PDAC was 931 Du/L. TK activity <931 and CA19-9 < 37 was prognostic for a longer survival, compared to patients with any or both TK activity >931 and CA19-9 > 37, with median 41.3 vs 8.6 months from sample to death (p < 0.001), and 3-year survival was 55.6% vs 8.9% (p < 0.001). Hazard ratio was 2.81 if any or both of TK or CA19-9 were above the cut-off value (p < 0.05).

Conclusion:

TKa in combination with CA19-9 outperforms each marker individually for prediction of survival. Overall survival is longer in patients with both TKa <931 Du/L and CA19-9 < 37. Further studies of TKa levels at different disease stages and correlation to outcome is warranted to find the full potential clinical usage of the TKa marker in PDAC.

Keywords:

• Plasma TK-1
• biomarker
• DiviTum
• pancreatic cancer
• prognostic indicator

Acknowledgments

The authors thank the patients that participated in the trial and hereby contributed to the results, and the staff at the Biobank BBk 1151. This study is part of the PhD of Ebba Asplund.

Author contributions

Study conception and design: EA, MB, JML. Acquisition of data: EA, MB, MK. Statistical analysis: EA. Drafting of the manuscript: all authors.

Disclosure statement

Mattias Bergqvist is an employee of Biovica and holds stock/stock options in the company. The other authors have no competing interests to declare.

Guarantor of the article: JML

All authors approved the final version of the article, including the authorship list.

Data availability statement

The data that support the findings of this study are available from the corresponding author, Ebba Asplund, upon reasonable request.

Additional information

Funding

This work was supported by Biovica International AB (application funding and DiviTum^® TKa analysis).