Biomarkers for early detection and screening in pancreatic cancer. Highlights from the 45th ASCO annual meeting. Orlando, FL, USA. May 29-June 2, 2009.

Pancreatic cancer is the second most frequent gastrointestinal malignancy with an unabated mortality that reflects the advanced stage of presentation. Detection of early disease through screening likely is the best way to meaningfully prolong survival. The development of biomarkers for screening holds enormous promise for increasing early detection and impacting mortality. Many biomarkers have been studied including the serum protein carbohydrate antigen 19-9, vascular endothelial growth factor, and nuclear factor kappa B, however, still no blood test or other fluid analysis reliably predicts patients with disease. The authors review abstracts from the 2009 annual meeting of the American Society of Clinical Oncology, Orlando, FL, U.S.A., that report evidence for early detection using a salivary biomarker array (#4630); a mucin epitope to PAM4 (#4613); a plasma nucleotide marker of hypoxia, miR-210 (#4624); and a cleavage product of complement pathway component C3b, iC3b (#4626). The meeting featured pancreatic cancer in over 100 research abstracts, of which, four are reviewed that focus on potential markers for early detection. When applied to a population of high risk patients, biomarkers of early pancreatic cancer could provide a minimally invasive way of identifying patients that require further evaluation using endoscopic tools. These molecular beacons may even be found to be sufficiently sensitive, specific, and cost effective to be applied to a broader population of patients.