TY - JOUR

T1 - Prognostic value of circulating proteins in patients undergoing surgery for pancreatic cancer

AU - Lindgaard, Sidsel C.

AU - Sztupinszki, Zsófia

AU - Maag, Emil

AU - Hansen, Carsten P.

AU - Chen, Inna M.

AU - Johansen, Astrid Z.

AU - Hasselby, Jane P.

AU - Bojesen, Stig E.

AU - Nielsen, Dorte

AU - Johansen, Julia S.

N1 - Funding Information: This study received funding from The Beckett Foundation, Foundation of Merchant M. Kristjan Kjær and wife Margrethe Kjær, Memorial Fund of Carpenter Holm, Celgene, VELUX Foundation, Harboe Foundation, and the Danish Cancer Society.

PY - 2023

Y1 - 2023

N2 - Background: Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer death. Less than 20% of patients are diagnosed with resectable disease. Identifying truly resectable disease is challenging because 20%–40% of the patients subjected to resection are found to have advanced disease during surgery. The aim of our study was to identify panels of circulating proteins that could be used to distinguish patients with unresectable PDAC from patients with resectable PDAC and to identify prognostic signatures for both groups. Methods: We measured 92 circulating immuno-oncology-related proteins using the proximity extension assay from Olink Proteomics in 273 patients eligible for surgery for PDAC. Two bioinformaticians worked independently of one another on the same data. LASSO and Ridge regression were used in the statistical analyses. Results: One protein index for determining resectability had an AUC value of 0.66. Several indices for prognosis had AUC values between 0.50 and 0.75 and were therefore not better than existing prognostic markers. Discussion: Our study did not reveal any new high-performing protein panels that could be used to identify patients with inoperable PDAC before surgery. The panel of 92 proteins investigated has previously been found to be applicable for diagnostic use in patients with PDAC, but it does not seem to warrant further investigation regarding resectability in the subgroup of patients with PDAC referred to surgery.

AB - Background: Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer death. Less than 20% of patients are diagnosed with resectable disease. Identifying truly resectable disease is challenging because 20%–40% of the patients subjected to resection are found to have advanced disease during surgery. The aim of our study was to identify panels of circulating proteins that could be used to distinguish patients with unresectable PDAC from patients with resectable PDAC and to identify prognostic signatures for both groups. Methods: We measured 92 circulating immuno-oncology-related proteins using the proximity extension assay from Olink Proteomics in 273 patients eligible for surgery for PDAC. Two bioinformaticians worked independently of one another on the same data. LASSO and Ridge regression were used in the statistical analyses. Results: One protein index for determining resectability had an AUC value of 0.66. Several indices for prognosis had AUC values between 0.50 and 0.75 and were therefore not better than existing prognostic markers. Discussion: Our study did not reveal any new high-performing protein panels that could be used to identify patients with inoperable PDAC before surgery. The panel of 92 proteins investigated has previously been found to be applicable for diagnostic use in patients with PDAC, but it does not seem to warrant further investigation regarding resectability in the subgroup of patients with PDAC referred to surgery.

KW - biomarkers

KW - pancreatic cancer

KW - proteins

KW - surgery

U2 - 10.1002/cam4.5240

DO - 10.1002/cam4.5240

M3 - Journal article

C2 - 36250429

AN - SCOPUS:85139941108

VL - 12

SP - 3972

EP - 3986

JO - Cancer Medicine

JF - Cancer Medicine

SN - 2045-7634

IS - 4

ER -