Publications

Publications

PANCAID publications

• Pancreatic incidentaloma: incidental f indings from history towards the era of liquid biopsy

  Matthias Löhr, Miroslav Vujasinovic, Nikolaos Kartalis, Philipp Osten
  
  Published: 9 September 2024
  
  Abstract
  This report provides an overview of the most common diagnostic methodss that bring to light incidental findings of pancreatic cancer. It reviews the impact of medical imaging and genetic assessment on the definitions of incidental findings and incidentaloma of the pancreas. For different diagnostic approaches (eg, MRI and CT) and for different affections (cysts/intraductal papillary mucinous neoplasia, solid lesions), specific guidelines have been proposed and some are established. Based on this, we summarise the differences between the traditional methods with those applied in the PANCAID project. Biomarkers, genetic predispositions, mutations and circulating tumour cells give rise to different levels of concern. The final part of the report discusses the risks and the opportunities associated with further diagnostic procedures and surgical interventions. From the ethical perspective, the most urging question is, can a screening based on liquid biopsy and blood samples open a gateway for the prevention of pancreatic cancer - even if morbidity and lethality of today’s surgical interventions is still very high?
  https://egastroenterology.bmj.com/content/2/3/e100082

• Multibiomarker panels in liquid biopsy for early detection of pancreatic cancer – a comprehensive review

  Kim‑Lea Reese, Klaus Pantel and Daniel J. Smit
  
  Published: 2 September 2024
  
  Abstract
  Pancreatic ductal adenocarcinoma (PDAC) is frequently detected in late stages, which leads to limited therapeutic options and a dismal overall survival rate. To date, no robust method for the detection of early-stage PDAC that can be used for targeted screening approaches is available. Liquid biopsy allows the minimally invasive collection of body fluids (typically peripheral blood) and the subsequent analysis of circulating tumor cells or tumor-associated molecules such as nucleic acids, proteins, or metabolites that may be useful for the early diagnosis of PDAC. Single biomarkers may lack sensitivity and/or specificity to reliably detect PDAC, while combinations of these circulating biomarkers in multimarker panels may improve the sensitivity and specificity of blood test-based diagnosis. In this narrative review, we present an overview of different liquid biopsy biomarkers for the early diagnosis of PDAC and discuss the validity of multimarker panels.
  https://jeccr.biomedcentral.com/articles/10.1186/s13046-024-03166-w

• Economic evaluations of pancreatic cancer screening: a systematic review protocol

  Robert Wittram, Hans-Helmut König, Christian Brettschneider
  
  Published: 17 August 2024
  
  Abstract
  Introduction: The early detection of pancreatic cancer is an important step in reducing mortality by offering patients curative treatment. Screening strategies in risk populations and by means of different detection methods have been economically evaluated. However, a synthesis of screening studies to inform resource allocation towards early detection within the disease area has not been done. Therefore, studies evaluating the cost-effectiveness and costs of screening for pancreatic cancer should be systematically reviewed.
  
  Methods and analysis: A systematic review of economic evaluations reporting the cost-effectiveness or costs of pancreatic cancer screening will be conducted. The electronic databases Medline, Web of Science and EconLit will be searched without geographical or time restrictions. Two independent reviewers will select eligible studies based on predefined criteria. The study quality will be assessed using the Consolidated Health Economic Evaluation Reporting Standards statement and the Bias in Economic Evaluation checklist. One reviewer will extract relevant data and a second reviewer will cross-check compliance with the extraction sheet. Key items will include characteristics of screened individuals, the screening strategies used, and costs, health effects and cost-effectiveness as study outputs. Differences of opinion between the reviewers will be solved by consulting a third reviewer.
  
  Ethics and dissemination: Ethics approval is not required for this study since no original data will be collected. The results will be disseminated through presentations at conferences and publication in a peer-reviewed journal. The results of the systematic review will inform future economic evaluations of pancreatic screening, which provide guidance for decision-making in healthcare resource prioritisation.
  https://bmjopen.bmj.com/content/14/8/e087003

• Can our experience with surveillance for inherited pancreatic cancer help to identify early pancreatic cancer in the general population?

  J.-Matthias Löhr, Daniel Öhlund, Emma Söreskog, Emil Andersson, Miroslav Vujasinovic, Niklas Zethraeus, Malin Sund
  
  Published: 5 March 2024
  
  Abstract
  Screening of the general population for cancer is a matter of primary prevention reducing the burden of disease. Whilst this is successful for several cancers including breast, colon and prostate, the situation to screen and hence prevent pancreatic cancer is different. The organ is not as accessible to simple physical exam or biological samples (fecal or blood
  test). Neither exists a blood test such as PSA that is cost-effective. Reviewing the evidence from screening risk groups for pancreatic cancer, one must conclude that there is no rational at present to screen the general population, for a lack of appropriate tests.
  https://doi.org/10.1007/s10689-024-00363-6

Background Literature

• UEG position paper on pancreatic cancer. Bringing pancreatic cancer to the 21st century: Prevent, detect, and treat the disease earlier and better

  Patrick Michl, Matthias Löhr, John P. Neoptolemos, et al. (2021)
  
  Research on pancreatic cancer has being receiving little or minimal funds
  from European funding bodies. UEG is calling for public‐private partnerships that
  would effectively fund research on pancreatic cancer.
  Conclusion: This would increase our understanding of this disease and better
  treatment, through pan‐European efforts that take advantage of the strong academic European research
  https://doi.org/10.1002/ueg2.12123

• Liquid Biopsy: From Discovery to Clinical Application

  Catherine Alix-Panabières and, Klaus Pantel (2021)
  
  Over the past 10 years, circulating tumor cells (CTC) and circulating tumor DNA (ctDNA) have received enormous attention as new biomarkers and subjects of translational research. Although both biomarkers are already used in numerous clinical trials, their clinical utility is still under investigation with promising first results. Clinical applications include early cancer detection, improved cancer staging, early detection of relapse, real-time monitoring of therapeutic efficacy, and detection of therapeutic targets and resistance mechanisms. Here, we propose a conceptual framework of CTC and ctDNA assays and point out current challenges of CTC and ctDNA research, which might structure this dynamic field of translational cancer research. SIGNIFICANCE: The analysis of blood for CTCs or cell-free nucleic acids called "liquid biopsy" has opened new avenues for cancer diagnostics, including early detection of tumors, improved risk assessment and staging, as well as early detection of relapse and monitoring of tumor evolution in the context of cancer therapies.
  https://pubmed.ncbi.nlm.nih.gov/33811121/

• Pancreatic Cancer: A Review of Current Treatment and Novel Therapies

  Hordur Mar Kolbeinsson, Sreenivasa Chandana, G. Paul Wright & Mathew Chung (2023)
  
  The paper provides information on the current treatment and novel therapies for pancreatic cancer, including the use of surgery, systemic chemotherapy, genomic testing, and targeted therapies. It does not specifically mention what is known about pancreatic cancer in general.
  https://www.doi.org/10.1080/08941939.2022.2129884

• A comprehensive review of pancreatic cancer and its therapeutic challenges

  Shan Jiang, Johan Bourghardt Fagman, Yunyun Ma, et al. (2022)
  
  The paper provides information on the molecular mechanisms of pancreatic cancer, drug resistance, immune escaping mechanisms, and potential therapeutic approaches. It also mentions that surgery is currently the only potentially curative treatment for pancreatic cancer patients.
  https://www.doi.org/10.18632/aging.204310

• Pancreatic Cancer: A Review of Risk Factors, Diagnosis, and Treatment

  ZhiYu Zhao and Wei Liu (2020)
  
  Pancreatic cancer is a highly invasive malignant tumor that mainly affects men and older adults. It is also increasingly observed in young patients.
  https://www.doi.org/10.1177/1533033820962117