Liquid biopsy approach to pancreatic cancer

Abstract

Pancreatic cancer (PC) continues to pose a major clinical challenge. There has been little improvement in patient survival over the past few decades, and it is projected to become the second leading cause of cancer mortality by 2030. The dismal 5-year survival rate of less than 10% after the diagnosis is attributable to the lack of early symptoms, the absence of specific biomarkers for an early diagnosis, and the inadequacy of available chemotherapies. Most patients are diagnosed when the disease has already metastasized and cannot be treated. Cancer interception is vital, actively intervening in the malignization process before the development of a full-blown advanced tumor. An early diagnosis of PC has a dramatic impact on the survival of patients, and improved techniques are urgently needed to detect and evaluate this disease at an early stage. It is difficult to obtain tissue biopsies from the pancreas due to its anatomical position; however, liquid biopsies are readily available and can provide useful information for the diagnosis, prognosis, stratification, and follow-up of patients with PC and for the design of individually tailored treatments. The aim of this review was to provide an update of the latest advances in knowledge on the application of carbohydrates, proteins, cell-free nucleic acids, circulating tumor cells, metabolome compounds, exosomes, and platelets in blood as potential biomarkers for PC, focusing on their clinical relevance and potential for improving patient outcomes.

Small RNA sequencing analysis of peptide-affinity isolated plasma extracellular vesicles distinguishes pancreatic cancer patients from non-affected individuals

“…Several studies have investigated the utility of EV-encapsulated biomarkers for the detection of PDAC (reviewed in 4 , 48 , 49 ). Many of these studies have focused on EV-RNA as a biomarker source and have found that differential expression analysis of specific miRNAs can differentiate between PDAC and non-affected individuals.…”

“…for the presence of disease biomarkers 4 , represents a promising approach for PDAC screening and detection. Typically, nucleic acids or proteins that circulate in a biofluid are analyzed during liquid biopsy; however, isolation of extracellular vesicles (EVs) from a biofluid and characterization of their cargoes, which include nucleic acids and proteins, is gaining interest 4 . Recent studies have explored the use of EV cargoes as biomarkers for PDAC 5 – 15 .…”

Unveiling the potential of galectin-3 as a diagnostic biomarker for pancreatic cancer: a review

“…Tissue biopsy is essential for achieving a definitive diagnosis of pancreatic cancer 36 . Various biopsy techniques are utilised, including FNA guided by imaging modalities such as EUS or CT and surgical biopsies 36 .…”

“…Tissue biopsy is essential for achieving a definitive diagnosis of pancreatic cancer 36 . Various biopsy techniques are utilised, including FNA guided by imaging modalities such as EUS or CT and surgical biopsies 36 . These procedures involve the collection of small samples of pancreatic tissue for histopathological examination, aiding in the confirmation of malignancy and determination of tumour type 36 .…”

Oncogenomic Changes in Pancreatic Cancer and Their Detection in Stool

“…If such lesions, which include pancreatic intraepithelial neoplasms, mucinous cystic neoplasms, IPMNs, and others, are surgically removed before they acquire the ability to invade, development of cancer can be impeded [ 29 , 129 ]. Several factors that differentiate PC from other pancreatic conditions and from healthy individuals, such as serum glycolipids and proteins, inflammatory and growth factors, autoantibodies, cytokines and chemokines, adhesion molecules, metabolites and DNA/RNA-based alterations, have been proposed as novel biomarkers for the early diagnosis of PC [ 11 , 13 , 130 ]. However, these have not yet been implemented in clinical practice, since evidence of their clinical value from large-scale studies is still missing [ 131 ].…”