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Can liquid biopsy aid in diagnosing and managing pancreatic cancer?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I am interested in understanding the potential applications of liquid biopsy in the detection and management of pancreatic cancer. Can you provide insights into how liquid biopsy techniques, such as circulating tumor DNA (ctDNA) analysis, are being utilized to detect pancreatic cancer at early stages or monitor disease progression? Additionally, what are some of the advantages and challenges associated with liquid biopsy compared to traditional tissue biopsies for diagnosing and monitoring pancreatic cancer? Kindly suggest.

Answered by Dr. Prabhakaran

Hello,

Welcome to icliniq.com.

I understand your concern.

The liquid biopsy concept is based on the observation that tumors shed evidence of their existence in the bloodstream. This evidence can be the tumor cells, their DNA (deoxyribonucleic acid), RNA (ribonucleic acid), or their proteins. Tumor cells grow aberrantly and die at a high rate, and thus shed a fair amount of material into the blood. Tumor cells can be used for liquid biopsies, but cells are hard to extract and analyze. DNA and proteins are fairly stable, and the technology to interpret them is very advanced. Cell seek applies these technologies to detecting DNA alterations that are common in tumors and also to detecting aberrant proteins that are commonly produced by cancer cells. None of these markers has much diagnostic value alone, but combined, they are highly accurate and rich in information.

The key technological advance in this paper is to improve the accuracy of detection of cancerous DNA mutations while maintaining high sensitivity. This technique was combined with a systematic search through a set of cancer biomarker proteins to identify DNA-protein “signatures” that indicate cancer. They did this work on a large and carefully characterized set of patients and healthy controls.

The result is that not only can CancerSEEK detect many types of cancer with high sensitivity, but can do so with very very few false positives. This last feature is incredibly important. Most people do not have cancer, so even a 2% false-positive rate will lead to more false positives than true positives. The CancerSEEK false positive rate is 0.9%. What is even more impressive - and qualifies this work as a breakthrough - is that the test works well on several cancers for which there are currently no screening tests available. Ovarian, liver, and pancreatic cancers are typically not detected until very late stages when they are essentially untreatable. We may well already have good treatments for these cancers in their early stages, but we have never even tested them because we cannot identify patients early enough to give them a try.

This is possibly the biggest single advance ever in cancer diagnostics. The scope and the execution of the work are simply outstanding. I expect this test to get better and I expect it to become a routine part of healthcare in the next decade. This is what an actual breakthrough looks like.

I hope this information helps you.

Thank you.

Answered byDr. Prabhakaran

Medically reviewed byiCliniq medical review team

Published At July 8, 2024
Reviewed AtJuly 8, 2024

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