Pancreatic ductal adenocarcinoma (PDAC) remains one of the most challenging malignancies to treat. Further, PDAC incidence continues to rise, particularly in younger adults. Current technologies rarely identify PDAC at an early stage. Thus, most diagnoses occur when the cancer has progressed to such an advanced disease that we have no efficacious treatment options.
A large team of researchers at various institutions across the United Kingdom has designed a clinical trial (NCT05727020) to test a unique screening method using a non-invasive breath test. The researchers already completed the first stage of the study, called the Volatile Organic Compound Assessment in PDAC (VAPOR), in which over 600 patients, including those with PDAC (N=205), benign pancreatic illnesses (N=205), and health controls (N=205), were studied. Each participant provided a breath sample using a single-use breathalyzer, and the research team used gas chromatography–mass spectrometry (GC-MS). The test identified volatile organic compounds (VOCs) in each sample. The researchers then developed a statistical model that includes VOC presence in relation to the PDAC. If successful, this model will allow doctors to predict patients at high risk of PDAC, long before they develop symptoms warranting current screening protocols. VAPOR 1 resulted in the discovery of a distinguishable profile of VOCs common to PDAC patients.
The researchers have not moved on to the next phase of the study, VAPOR 2, which aims to validate the breath test to detect PDAC in patients with upper gastrointestinal (GI) indications. VAPOR2 plans to recruit 6,000 patients with GI symptoms who are referred for PDAC screening by endoscopy and pathological review. Participants will receive a breath test, with results available before the pathology reports.
Pancreatic Cancer UK, the charity funding the study, stated that the opening of the trial was “the most significant step toward a life-saving breakthrough in 50 years”. A successful conclusion of the trial could validate the ability of a breath test to identify PDAC at early stages. This discovery could have a significant impact on PDAC survivorship by enabling earlier diagnosis and more viable treatment options.
Sources: Gastroenterol, BMJ Open, Independent
