Perspective from Tyler Stevens, MD
Disclosures: The study was funded by funding from EMBL, CNIO, World Cancer Research, the European Research Council, the BMBF-funded Heidelberg Centre for Human Bioinformatics within the German Network for Bioinformatics Infrastructure, Health Research Fund at Carlos III Health Institute-FEDER, Thematic Network for Cooperative Cancer Research, III Carmen Delgado/Miguel Pérez-Mateo scholarship of AESPANC-ACANPAN, EU-6FP Integrated Project and EU-FP7-HEALTH.
March 08, 2022
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Stool-based screening shows promise in early detection of pancreatic cancer

Perspective from Tyler Stevens, MD
Disclosures: The study was funded by funding from EMBL, CNIO, World Cancer Research, the European Research Council, the BMBF-funded Heidelberg Centre for Human Bioinformatics within the German Network for Bioinformatics Infrastructure, Health Research Fund at Carlos III Health Institute-FEDER, Thematic Network for Cooperative Cancer Research, III Carmen Delgado/Miguel Pérez-Mateo scholarship of AESPANC-ACANPAN, EU-6FP Integrated Project and EU-FP7-HEALTH.
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Fecal microbiota-based screening may help with early detection of pancreatic ductal adenocarcinoma, according to a study published in Gut.

“The study identified a fecal microbiome signature that robustly detects pancreatic cancer at high disease specificity,” Nuria Malats, MD, PhD, study author and head of the genetic and molecular epidemiology group at the Spanish National Cancer Research Center in Madrid, told Healio. “The fact that this uses noninvasive obtained samples (stool) makes this panel a potential test towards cost-effective [pancreatic ductal adenocarcinoma (PDAC)] screening and monitoring.”

Malats and colleagues analyzed stool and saliva samples from a Spanish case-control study that included 57 newly diagnosed cases, 50 controls and 29 patients with chronic pancreatitis in the discovery phase, as well as 76 cases from a German case-control study in the validation phase.

According to study results, fecal metagenomic classifiers performed significantly better compared with saliva-based classifiers, with investigators noting that fecal classifiers identified patients with PDAC with an accuracy of 0.84 area under the receiver operating characteristic curve (AUROC) in the Spanish cohort, based on a set of 27 microbial species. This value improved to 0.94 AUROC after investigators combined their microbiome-based predictions with serum levels of carbohydrate antigen (CA) 19–9, an FDA-approved, low-specificity PDAC diagnostic biomarker.

Investigators further validated the classifiers in the German PDAC cohort with an accuracy of 0.83 AUROC and confirmed PDAC disease specificity against 25 publicly available gut metagenomes from global study populations.

“The described fecal microbiome signatures enabled robust metagenomic classifiers for PDAC detection at high disease specificity, complementary to existing markers and with potential towards cost-effective PDAC screening and monitoring,” Malats and colleagues concluded.