Genetic Test Detects Some Pancreatic Cancers

December 6th, 2017

Fluid-filled pancreatic cysts are often seen on abdominal imaging tests, but predicting which cysts are benign and which may turn into potentially life-threatening pancreatic cancer has been difficult. However, new findings from University of Pittsburgh researchers show that a genetic test developed at UPMC called PancreaSeq® is highly effective in determining which pancreatic cysts are most likely to be associated with one of the most aggressive types of pancreatic cancer. The study, which tested 595 participants and evaluated results from the 102 who went on to have surgery, found that with 100 percent accuracy PancreaSeq correctly classified every patient in the evaluation group who had a common precursor to pancreatic cancer called intraductal papillary mucinous neoplasm (IPMN) and also correctly identified the cysts that would eventually progress to being cancerous. The test was less accurate for the less common pancreatic cyst type called mucinous cystic neoplasm (MCN), identifying only 30 percent of the cases. Importantly, PancreaSeq did not identify any false positives in either cyst type.

Determining which cysts may progress to pancreatic cancer—which has one of the lowest survival rates of all cancers—can help doctors decide which cysts should be surgically removed. “On the one hand, you never want to subject a patient to unneeded surgery. But survival rates for pancreatic cancer are much better if it is caught before symptoms arise, so you also don’t want to ignore an early warning sign,” said lead author Aatur D. Singhi, MD, PhD. “This rapid, sensitive test will be useful in guiding physicians on which patients would most benefit from surgery.” Singhi and his team at UPMC developed PancreaSeq, which requires a small amount of fluid removed from the cyst to test for 10 different tumor genes associated with pancreatic cancer. An improved version of PancreaSeq that incorporates additional tumor genes associated with pancreatic cancer currently is undergoing rigorous clinical testing, according to Singhi. In the future, the team notes, clinical guidelines will need to be revisited to explore incorporating tests like PancreaSeq.

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