Blood test makes early detection of pancreatic cancer with 85% accuracy

The test – dubbed PAC-MANN – has been developed at Oregon Health and Science University

A novel blood testing technique could help detect pancreatic cancer in the clinic earlier and hence improve survival rates for one of the deadliest cancers.

Researchers at Oregon Health and Science University (OHSU) have developed a test they have memorably called ‘PAC-MANN’ – which is an abbreviation for ‘Protease ACtivity-based assay using a MAgnetic NaNosensor’ – which uses a small blood sample to detect changes in protease activity which is a key indicator of pancreatic ductal adenocarcinoma (PDAC) and the deadliest and most common form of pancreatic cancer.

Current tests, such as carbohydrate antigen 19-9, or CA 19-9, are good at indicating prognosis, but aren’t sensitive enough for early-stage detection. The PAC-MANN test addresses this current diagnostic limitation by earlier identification of signs of cancer-related activity in the blood.

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“The problem with pancreatic cancer is that we often catch it too late,” said Dr. Jared Fischer, at OHSU Knight Cancer Institute’s Cancer Early Detection Advanced Research Center (CEDAR).

“Our goal with PAC-MANN is to give clinicians a tool that can detect the disease much earlier, when more treatment options are available and there is a better chance of survival.”

The study’s lead author, Dr. Jose L. Montoya Mira is a research engineer at OHSU’s CEDAR project. Both an engineer and biologist by training, he joined the collaborative team to bring his experience to create a more cost-effective, high-throughput test that could be used anywhere, not just at speciality labs or large medical centres.

“Our test could be used for people at high risk of pancreatic cancer, which is not targeted by current tests,” he said.

“It allows for a more robust and less invasive screening, unlike an endoscopic ultrasound and other liquid biopsy tests that require larger volumes of blood. This allows our test to be performed easily and more frequently for earlier detection.”

The researchers created a non-invasive test using blood samples from a cohort of 350 patients of OHSU’s Brenden-Colson Center for Pancreatic Care and CEDAR. The subjects either already had pancreatic cancer, or were at high-risk for cancer, or were control subjects.

The research team looked for certain proteins – specifically proteases – in the blood that are known to become more active in people with PDAC. By identifying these proteins, they developed a test that could specifically detect pancreatic cancer. 

The PAC-MANN test was able to correctly distinguish patients with pancreatic cancer from healthy patients and those with non-cancerous pancreatic issues 98% of the time. It also helped spot early-stage cancer with 85% accuracy when used along with the CA 19-9 test.

The findings also showed that PAC-MANN could detect how well treatments were working. Post-surgery, the research team observed a decrease in protease activity, suggesting the test could help monitor whether interventional treatments had been effective.

“This test isn’t just about detection. It could also help us measure how well treatments are working and guide [future] therapeutic options,” Fischer said.

“If we can track a patient’s response to therapy in [near] real time, we can … improve outcomes.”

Unlike traditional tests, PAC-MANN requires only a small blood sample and provides a simple fluorescent readout, making it a quick and accessible option for screening.

“The big difference with this test is cost: It takes only eight microliters of blood and 45 minutes to run the test at a cost of less a (US$) dollar per 100 samples,” Montoya said.

Montoya and Fischer have plans for more trials, specifically an investigator-initiated trial in collaboration with the OHSU Knight Cancer Institute and CEDAR in patients at high risk of developing pancreatic cancer.

In addition to Fischer and Montoya, OHSU co-authors included: Arnaud Quentel, MSc., Dr Ranish Patel, Dr Dove Keith, Megan Sousa, BSc., Dr. Jessica Minnier, Dr. Benjamin Kingston, Dr. Larry David, Dr. Sadik Esener, Dr. Rosalie Sears, Dr. Charles Lopez, Dr. Brett Sheppard, Dr. Melissa Wong and Dr. Utkan Demirci with the Stanford University School of Medicine.

For further reading please visit: 10.1126/scitranslmed.adq3110