Queen Mary University of London has developed the world’s first urine test for detecting pancreatic cancer, potentially improving survival rates by as much as 60%.
The test has been developed to spot warning signs of the disease in the earliest stages. Often called the ‘silent killer’, pancreatic cancer has the lowest survival rate with around 5% of patients still alive five years after being diagnosed.
The non-invasive test has been developed by Professor Tatjana Crnogorac-Jurcevic of Barts Cancer Institute, Queen Mary University of London, and has reached the final stage of validation before being developed for use with patients. Professor Crnogorac-Jurcevic has been developing the as yet unnamed test for 10 years.
Professor Tatjana said: “The pancreatic cancer most likely grows for a decade or longer so there is a large “window of opportunity” where we can detect it. At the moment, we only detect late stage cancers.”
She added: “If we can detect pancreatic cancer when it’s still operable and when the tumours are small and not yet spread to other organs, we could see a significant impact on patient survival. Removing tumours that are 1cm or smaller can increase five-year survival to around 60 per cent.”
Early trials of the test have been shown to be 90% accurate and can spot the disease five years before symptoms show.
Pancreatic cancer kills nearly 10,000 people in UK every year and 56,770 in the US, according to estimates. A quarter of patients with the disease die within a month of being diagnosed, and three quarters will die within a year.
But a leading pancreatic cancer charity hailed the urine test, which gives results within 24 hours, as a breakthrough that is ‘desperately needed’. The first urine test in the world could increase survival rates by more than 50% if successfully rolled out, scientists have said.
The test works by measuring three proteins – LYVE1, TFF1 and REG1B – secreted in the body by pancreatic cancer and present in the urine. Using an algorithm, a risk score is calculated which will indicate if a patient needs further testing. It is not a diagnostic test, rather a diagnostic aid.
The team at Queen Mary tested the biomarkers on human samples, publishing their findings in the journal Clinical Cancer Research in 2015. The test will now go through a £1.6million clinical study, called UroPac, funded by medical research charity the Pancreatic Cancer Research Fund (PCRF). The 3,000 participants will be sourced be referral by their GP if they have suspected symptoms, or if they have a family history of the disease.
The study is expected to take around four years, but if successful, it will be ready to be used by clinicians immediately.
Professor Crnogorac-Jurcevic said: “In around 10% of pancreatic cancers, there is family background. Those individuals are currently being tested using invasive procedures, so the compliance isn’t great. They may have imaging with CT scan, MRI, or an endoscopic ultrasound scan (EUS) together with a biopsy if a diagnosis is still not clear after having a CT scan. An EUS is very unpleasant and you have to be sedated.”
During a EUS, a thin, flexible tube is passed through the mouth and down into your stomach to collect images of where cancer may be.
Professor Crnogorac-Jurcevic said: “We would like to establish the accuracy of our test compared to radioactive imaging to see if they are as good or better, and then implement it before those tests need to be done.”
Dr Chris MacDonald, head of research at Pancreatic Cancer UK, said: “A non-invasive test to help provide earlier diagnosis for pancreatic cancer is desperately needed if we’re to see the first improvements in survival for decades. Pancreatic cancer is incredibly adept at evading detection by our immune system, and its vague symptoms – like back pain or indigestion – pose a huge challenge for doctors. All too often the disease is able to develop unnoticed until it is tragically too late for patients and their loved ones.”