A liquid biopsy exosomal microRNA (miRNA) panel can accurately predict cancer recurrence following surgery for pancreatic ductal adenocarcinoma, according to a study presented at Digestive Disease Week (DDW) 2021.

“Even for the most favourable cohort of patients with resectable pancreatic ductal adenocarcinoma, up to 80% of patients experience a recurrence after surgery, with a short recurrence-free interval,” said Satoshi Nishiwada, MD, Nara Medical University, Nara, Japan. “Risk-stratification before treatment is essential for offering individualised treatment strategies; however, pre-treatment recurrence prediction remains a clinical challenge.”

“Using genome-wide expression profiling, we identified and developed a noninvasive, exosomal miRNA signature for predicting recurrence in patients with pancreatic ductal adenocarcinoma,” she said.

The researchers analysed a total of 210 plasma specimens from patients with pancreatic ductal adenocarcinoma, some who underwent neoadjuvant therapy (NAT) and some who did not. Of the patients, 25 underwent small RNA sequencing.

“The small RNA-Seq profiling of pre-treatment samples from recurrence-positive and recurrence negative patients after surgery led to the identification of an exosomal miRNA panel for recurrence prediction,” said Dr. Nishiwada.

The researchers then optimised and trained a 6-exosomal miRNA risk-prediction model. In the training cohort (n = 82 patients), the prediction model robustly discriminated patients with cancer recurrence (area under the curve [AUC] = 0.81, 95% confidence interval [CI], 0.70-0.89) and relapse-free survival (P

In an independent validation cohort of 57 patients, the miRNA panel exhibited comparable performance for relapse-free survival (P

The performance of the model among the 46 patients that were part of the pos-NAT cohort was also comparable for cancer recurrence (AUC = 0.72; 95% CI, 0.57-0.85) and relapse-free survival (P

“Availability of such a liquid biopsy assay will have clinical significance for the selection of individualised treatment strategies and designing future genome-guided prospective clinical trials for patients with pancreatic