Freedom from PDAC
This November, we have bountiful thanks to give, celebrated in Thanksgiving and honored in Pancreatic Cancer Awareness Month. We’re gratefully gobbling up the progress made in the battle for early detection of pancreatic cancer, explored in a paper published earlier this year titled, Multimodal Pancreatic Cancer Detection Using Methylated DNA Biomarkers in Pancreatic Juice and Plasma CA 19-9: A Prospective Multicenter Study. In this study, doctors have replicated results of a previous paper and indicated “PJ-MDMs (Pancreatic Juice – Methylated DNA Markers) accurately detect early stages of PDAC (Pancreatic Ductal Adenocarcinoma) and justifies further clinical test development.”1
While the test group didn’t include any stage 0 findings of PDAC, 33% of the patients in this study had stages 1 or 2.1 The combination of 3-MDM PJ model + CA 19-9 had a specificity of 88% with a sensitivity for these early-stages of PDAC at an average of 89%.1 This high rate of sensitivity for early-stage PDAC indicates the ability to detect cancer much earlier than clinically diagnosing it at a localized stage, which typically indicates stages 3 or 4 when the cancer has spread or become inoperable, and the survivability outcome decreases significantly 1,2. In fact, by the time patients are diagnosed with PDAC, 85% of them are in these later stages.2
Of course, diagnostic testing differs from surveillance testing and provides additional barriers to success. One barrier to creating a widespread screening test is the degradation of DNA over a 24-hour period after collecting pancreatic juice. If we are to expect hundreds or even thousands of samples to be collected on a daily basis, samples cannot be examined immediately, by sheer numbers alone. This is where a second study comes into play. At this year’s American Pancreatic Association Annual Meeting, members of Mayo Clinic presented information on stabilizing these DNA samples. In their findings, it was determined that a 1:1 ratio of EDTA buffer to pancreatic juice was the most successful at preserving the DNA after 24 hours.4
Another of these barriers is the chance of procedure-related pancreatitis stemming from pancreatic duct cannulation. Here, the findings in the first study are highly important. Instead of cannulating the pancreas, the study had doctors aspirate secretin-stimulated duodenal fluid.1 This demonstrates you can preserve the diagnostic abilities of a pancreatic juice panel while also minimizing risk to the patient.1 Secretin is known to have minimal side effects, if any; the most common of which is nausea or flushing of the cheeks, both of which pass within a few minutes.3
PJ-MDMs panels taking one step closer to becoming a screening method for early detection means we’re one step closer to countless lives being saved. What better news to celebrate as we gather round with precious loved ones this Thanksgiving?
1Majumder, S., Wallace, M. B., Engels, M. M., Abu Dayyeh, B. K., Raimondo, M., Mahoney, D. W., & Rajan, E. (2025, April 1). Multimodal Pancreatic Cancer Detection Using Methylated DNA Biomarkers in Pancreatic Juice and Plasma CA 19-9: A Prospective Multicenter Study. Clinical Gastroenterology and Hepatology, 23(5), 766-775. doi:10.1016/j.cgh.2024.07.048
2Medstar Health. (2016, November). Why Is Pancreatic Cancer So Deadly and What Are the Treatment Options. MedStar Health Blog. Retrieved from https://www.medstarhealth.org/blog/pancreatic-cancer-deadly-treatment-options
3ChiRhoClin, Inc. (2017, July). Full Prescribing Information. Retrieved from ChiRhoClin.com: https://www.chirhoclin.com/wp-content/uploads/2022/07/Updated-Long-Form-PI.pdf
4Mills, K., Taylor, W., Berger, C., Foote, P., Mahoney, D., Berger, K., . . . Majumder, S. (2025). Optimization of Endoscopically Collected Pancreatic Juice for Enhanced DNA Yield for Detection of Pancreatic Ductal Adenocarcinoma. Mayo Clinic.