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Case Report: Early detection of pancreatic pre-cancer lesion in multimodal approach with exosome liquid biopsy

BACKGROUND: The detection of pancreatic ductal adenocarcinoma (PDAC) lesions at pre-cancerous or early-stages is critical to improving patient survival. We have developed a liquid biopsy test (ExoVita(®)) based on the measurement of protein biomarkers in cancer-derived exosomes. The high sensitivity...

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Autores principales: Dhani, Harmeet, Hinestrosa, Juan Pablo, Izaguirre-Carbonell, Jesus, Balcer, Heath I., Kurzrock, Razelle, Billings, Paul R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10210587/
https://www.ncbi.nlm.nih.gov/pubmed/37251939
http://dx.doi.org/10.3389/fonc.2023.1170513
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author Dhani, Harmeet
Hinestrosa, Juan Pablo
Izaguirre-Carbonell, Jesus
Balcer, Heath I.
Kurzrock, Razelle
Billings, Paul R.
author_facet Dhani, Harmeet
Hinestrosa, Juan Pablo
Izaguirre-Carbonell, Jesus
Balcer, Heath I.
Kurzrock, Razelle
Billings, Paul R.
author_sort Dhani, Harmeet
collection PubMed
description BACKGROUND: The detection of pancreatic ductal adenocarcinoma (PDAC) lesions at pre-cancerous or early-stages is critical to improving patient survival. We have developed a liquid biopsy test (ExoVita(®)) based on the measurement of protein biomarkers in cancer-derived exosomes. The high sensitivity and specificity of the test for early-stage PDAC has the potential to improve a patient’s diagnostic journey in hopes to impact patient outcomes. METHODS: Exosome isolation was performed using alternating current electric (ACE) field applied to the patient plasma sample. Following a wash to eliminate unbound particles, the exosomes were eluted from the cartridge. A downstream multiplex immunoassay was performed to measure proteins of interest on the exosomes, and a proprietary algorithm provided a score for probability of PDAC. RESULTS: We describe the case of a 60-year-old healthy non-Hispanic white male with acute pancreatitis who underwent numerous invasive diagnostic procedures that failed to detect radiographic evidence of pancreatic lesions. Following the results of our exosome-based liquid biopsy test showing "High Likelihood of PDAC", in addition to KRAS and TP53 mutations, the patient decided to undergo a robotic pancreaticoduodenectomy (Whipple) procedure. Surgical pathology confirmed the diagnosis of high-grade intraductal papillary mucinous neoplasm (IPMN), which was consistent with the results of our ExoVita(®) test. The patient’s post-operative course was unremarkable. At five-month follow-up, the patient continued to recover well without complications, in addition to a repeat ExoVita test which demonstrated “Low Likelihood of PDAC”. CONCLUSION: This case report highlights how a novel liquid biopsy diagnostic test based on the detection of exosome protein biomarkers allowed early diagnosis of a high-grade precancerous lesion for PDAC and improved patient outcome.
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spelling pubmed-102105872023-05-26 Case Report: Early detection of pancreatic pre-cancer lesion in multimodal approach with exosome liquid biopsy Dhani, Harmeet Hinestrosa, Juan Pablo Izaguirre-Carbonell, Jesus Balcer, Heath I. Kurzrock, Razelle Billings, Paul R. Front Oncol Oncology BACKGROUND: The detection of pancreatic ductal adenocarcinoma (PDAC) lesions at pre-cancerous or early-stages is critical to improving patient survival. We have developed a liquid biopsy test (ExoVita(®)) based on the measurement of protein biomarkers in cancer-derived exosomes. The high sensitivity and specificity of the test for early-stage PDAC has the potential to improve a patient’s diagnostic journey in hopes to impact patient outcomes. METHODS: Exosome isolation was performed using alternating current electric (ACE) field applied to the patient plasma sample. Following a wash to eliminate unbound particles, the exosomes were eluted from the cartridge. A downstream multiplex immunoassay was performed to measure proteins of interest on the exosomes, and a proprietary algorithm provided a score for probability of PDAC. RESULTS: We describe the case of a 60-year-old healthy non-Hispanic white male with acute pancreatitis who underwent numerous invasive diagnostic procedures that failed to detect radiographic evidence of pancreatic lesions. Following the results of our exosome-based liquid biopsy test showing "High Likelihood of PDAC", in addition to KRAS and TP53 mutations, the patient decided to undergo a robotic pancreaticoduodenectomy (Whipple) procedure. Surgical pathology confirmed the diagnosis of high-grade intraductal papillary mucinous neoplasm (IPMN), which was consistent with the results of our ExoVita(®) test. The patient’s post-operative course was unremarkable. At five-month follow-up, the patient continued to recover well without complications, in addition to a repeat ExoVita test which demonstrated “Low Likelihood of PDAC”. CONCLUSION: This case report highlights how a novel liquid biopsy diagnostic test based on the detection of exosome protein biomarkers allowed early diagnosis of a high-grade precancerous lesion for PDAC and improved patient outcome. Frontiers Media S.A. 2023-05-11 /pmc/articles/PMC10210587/ /pubmed/37251939 http://dx.doi.org/10.3389/fonc.2023.1170513 Text en Copyright © 2023 Dhani, Hinestrosa, Izaguirre-Carbonell, Balcer, Kurzrock and Billings https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Dhani, Harmeet
Hinestrosa, Juan Pablo
Izaguirre-Carbonell, Jesus
Balcer, Heath I.
Kurzrock, Razelle
Billings, Paul R.
Case Report: Early detection of pancreatic pre-cancer lesion in multimodal approach with exosome liquid biopsy
title Case Report: Early detection of pancreatic pre-cancer lesion in multimodal approach with exosome liquid biopsy
title_full Case Report: Early detection of pancreatic pre-cancer lesion in multimodal approach with exosome liquid biopsy
title_fullStr Case Report: Early detection of pancreatic pre-cancer lesion in multimodal approach with exosome liquid biopsy
title_full_unstemmed Case Report: Early detection of pancreatic pre-cancer lesion in multimodal approach with exosome liquid biopsy
title_short Case Report: Early detection of pancreatic pre-cancer lesion in multimodal approach with exosome liquid biopsy
title_sort case report: early detection of pancreatic pre-cancer lesion in multimodal approach with exosome liquid biopsy
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10210587/
https://www.ncbi.nlm.nih.gov/pubmed/37251939
http://dx.doi.org/10.3389/fonc.2023.1170513
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