Circulating Nucleic Acids as Novel Biomarkers for Pancreatic Ductal Adenocarcinoma

Abstract

Despite considerable advancements in the clinical management of PDAC it remains a significant cause of mortality. PDAC is often diagnosed at advanced stages due to vague symptoms associated with early-stage disease and a lack of reliable diagnostic biomarkers. Late diagnosis results in a high proportion of cases being ineligible for surgical resection, the only potentially curative therapy for PDAC. Furthermore, a lack of prognostic biomarkers impedes clinician’s ability to properly assess the efficacy of therapeutic interventions. Advances in our ability to detect circulating nucleic acids allows for the advent of novel biomarkers for PDAC. Tumor derived circulating and exosomal nucleic acids allow for the detection of PDAC-specific mutations through a non-invasive blood sample. Such biomarkers could expand upon the currently limited repertoire of tests available. This review outlines recent developments in the use of molecular techniques for the detection of these nucleic acids and their potential roles, alongside current techniques, in the diagnosis, prognosis and therapeutic governance of PDAC.

Circulating Cell-Free Nucleic Acids as Biomarkers for Diagnosis and Prognosis of Pancreatic Cancer

“…All these studies use a G12/G13 mutation panel as a target for KRAS mutations, which includes the regions mutated in PDAC by NGS or dPCR. As reviewed by [ 200 ], exo KRAS have demonstrated greater sensitivity and specificity in predicting disease progression compared to ctDNA KRAS [ 201 , 202 ]. Allenson et al [ 203 ] found that for predicting PDAC status, the sensitivity and specificity were 75.4% and 92.6%, respectively, and positive KRAS mutation from exoDNA was significantly associated with early-stage PDAC.…”