Development of novel diagnostic pancreatic tumor biomarkers

Abstract

As the incidence of pancreatic ductal adenocarcinoma cancer (PDAC) increases, the need to improve the outcome for patients with this deadly disease becomes all the more pressing. Earlier detection of PDAC has the potential to improve survival, and biomarkers that enable earlier diagnosis are sought after. Some of the challenges associated with developing new diagnostic biomarkers for PDAC are reviewed here, including the need for appropriate control groups and the necessity to account for established confounding factors such as obstructive jaundice. High-risk groups, including individuals with new-onset diabetes, are discussed, and the findings of studies utilizing samples from pre-diagnostic cohorts to monitor changes in biomarker levels occurring in the weeks and months prior to diagnosis of PDAC are appraised. Progress toward identification of specific biomarker types is provided, and a variety of sources of biomarkers are examined, including blood, urine, pancreatic juice, gut lavage fluid, and extracellular vesicles. Additionally, a range of biomarker types are reviewed, including protein biomarkers, circulating tumor cells, circulating tumor DNA, and micro- RNAs. New developments with respect to emerging biomarkers, such as metabolites, are also examined. While progress to date has been slow, clear advances are being made, and the promise of biomarkers with clinical utility is in reach.