A urine test that can detect early stage pancreatic cancer has reached the final stage of validation before being developed for use with patients.
If successful, this non-invasive urine test would be the first in the world to help clinicians detect the highly lethal cancer at an early stage - enabling many more people to have surgery to remove their tumour, which is currently the only potentially curative treatment.
The UroPanc clinical study is being led by Professor Tatjana Crnogorac-Jurcevic of Barts Cancer Institute, Queen Mary University of London, thanks to £1.6M funding from the medical research charity Pancreatic Cancer Research Fund (PCRF).
The test works by measuring levels of three specific proteins found in urine that were identified by Professor Crnogorac-Jurcevic as biomarkers of early stage pancreatic cancer. The biomarkers have been shown to detect early stage pancreatic cancer with nearly 95% accuracy in urine samples from pancreatic cancer patients, patients with other diseases of the pancreas and healthy volunteers.
The UroPanc study will now further validate these protein biomarkers in a clinical setting with over 3,000 people. If the clinical study confirms the accuracy of the biomarkers, a standardised urine test will be developed for clinicians to use as a diagnostic aid.
Nearly 10,000 people are diagnosed with pancreatic cancer each year in the UK. Only around 5 in every 100 patients will live for 5 years or more beyond their diagnosis. This is the lowest survival rate of any common cancer and it has barely improved in over 40 years. The low survival rate is partly due to late diagnosis – more than 85 per cent of patients are diagnosed too late for surgery and treatment options for these patients are limited. Most will die within 6-12 months.
The 4-year study will recruit two groups of people. The ‘symptomatic’ group will be drawn from patients whose GP suspects pancreatic cancer because of their symptoms, and who are referred to one of three study partner hospitals - University College London Hospital, the Royal Free Hospital or the Royal London Hospital. In addition to the standard investigations and assessments that these patients will undergo, a urine sample will be collected for testing and the results will be compared with the results of their diagnosis made by conventional means.
The second ‘asymptomatic’ group will be recruited from the EUROPAC registry, based at the University of Liverpool. EUROPAC’s database includes more than 400 individuals who are classed as having a higher risk of developing pancreatic cancer, for example, because of a family history of the disease. Individuals recruited to the UroPanc study, some of whom already have regular pancreatic imaging such as endoscopic ultrasound, CT or MRI scans under the EUROPAC screening programme, will have a urine sample collected for testing.
Professor Tatjana Crnogorac-Jurcevic from Queen Mary University of London, said: “We’ve been working on this biomarker research for over ten years and I’m excited to reach this stage. If we can detect pancreatic cancer when it’s still operable and when the tumours are small and not yet spread to other organs, we could see a significant impact on patient survival; removing tumours that are 1cm or smaller can increase 5-year survival to around 60%.”
Pancreatic Cancer Research Fund’s founder and CEO, Maggie Blanks, says: “Because symptoms of pancreatic cancer are vague and often mistaken for less lethal conditions, being able to rule in or rule out pancreatic cancer much more quickly would be a major step forward in speeding up the diagnostic pathway. It would mean that many more patients would be eligible for surgery or could start other treatment much sooner.
“This is the largest single investment in a research project that PCRF has made to date, but we felt it was worth the risk because the need for early detection is so urgent. We hope the biomarkers fulfil the potential they’ve shown so far.”
Further information and interviews:
For interviews with Professor Crnogorac-Jurcevic, please contact:
Chris Mahony, Communications Executive (School of Medicine and Dentistry), Queen Mary University of London Email: firstname.lastname@example.org Tel: +44 0207 8825315
For interviews with Maggie Blanks, Pancreatic Cancer Research Fund, please contact:
Jo Kelly, Campus PR, Email email@example.com Tel: +44 0113 2589880 / +44 07980 267756
MP4 files of Professor Crnogorac-Jurcevic discussing this research are available.
Photos available (credit: Pancreatic Cancer Research Fund)
Symptoms graphic available (credit: Pancreatic Cancer Research Fund)
Notes to editors
About pancreatic cancer
Pancreatic cancer is often diagnosed late because when symptoms develop, they can be non-specific, can vary depending where the tumours are situated and are often mistaken for other less lethal conditions. Symptoms include abdominal and upper back pain, jaundice, indigestion, pale stools or loose oily stools, loss of appetite and late onset diabetes (not attributable to weight gain).
There are few treatment options for pancreatic cancer patients and the cancer will become resistant to chemotherapy. Most patients die 6-12 months after diagnosis. The 5-year survival rate is the lowest for any common cancer, at around 5 per cent. The 10-year survival rate is 1 per cent.
Pancreatic Cancer Research Fund (PCRF) www.pcrf.org.uk
PCRF is the only medical research charity exclusively funding research into pancreatic cancer in the UK and Ireland. To date, the charity has funded 59 research projects worth over £9 million. In January 2016 PCRF launched a £2 million national pancreas tissue bank – the first in the world - to accelerate research into the disease. All funding used to support research comes from public fundraising and donations.
About Queen Mary University of London
At Queen Mary University of London, we believe that a diversity of ideas helps us achieve the previously unthinkable.
In 1785, Sir William Blizard established England’s first medical school, The London Hospital Medical College, to improve the health of east London’s inhabitants. Together with St Bartholomew’s Medical College, founded by John Abernethy in 1843 to help those living in the City of London, these two historic institutions are the bedrock of Barts and The London School of Medicine and Dentistry.
Today, Barts and The London continues to uphold this commitment to pioneering medical education and research. Being firmly embedded within our east London community, and with an approach that is driven by the specific health needs of our diverse population, is what makes Barts and The London truly distinctive.
Our local community offer to us a window to the world, ensuring that our ground-breaking research in cancer, cardiovascular and inflammatory diseases, and population health not only dramatically improves the outcomes for patients in London, but also has a far-reaching global impact.
This is just one of the many ways in which Queen Mary is continuing to push the boundaries of teaching, research and clinical practice, and helping us to achieve the previously unthinkable.
About the EUROPAC registry
The European Registry of Hereditary Pancreatitis and Familial Pancreatic Cancer (EUROPAC) is a collaborative study involving pancreas specialists from around Europe.
EUROPAC registry members are assessed for suitability for screening and if their risk is considered high enough that they will benefit, they are invited for pancreatic imaging (endoscopic ultrasound, CT or MRI) on a one or 3 yearly basis. These screened participants and other members of the registry, who may not be in the formal screening programme, will have urine samples collected for the UroPanc study.
The UroPanc study team:
Professor Tatjana Crnogorac-Jurcevic, Barts Cancer Institute, Queen Mary University of London (QMUL)
Professor Steve Pereira, consultant gastroenterologist at University College London Hospitals NHS Foundation Trust (UCLH)
Dr Patrick Wilson, consultant gastroenterologist at The Royal London Hospital
Professor Bill Greenhalf, lead scientist, EUROPAC, based at University of Liverpool
Prof Stephen Duffy, Professor of Cancer Screening in the Centre for Cancer Prevention, Queen Mary University of London
Dr Oleg Blyuss, statistician, Centre for Cancer Prevention, Queen Mary University of London
Dr Nirdesh K Gupta, co-founder of 3rd Street Diagnostics, Cedars-Sinai Medical Centre, Los Angeles
Dr Melody Zhifang Ni, senior methodologist, NIHR London In Vitro Diagnostics Co-operative