With NETs, particularly pancreatic NETs, due to a lack of efficient prognostic markers, it is difficult to identify which cases are more likely to metastasise than others. Identifying whether cysts will turn cancerous is also another area requiring a screening program as a standard of care to monitor.   Molecular testing is advancing and this test I’m reporting here looks like good news in the case of assessing the risks of pancreatic cysts.  Pancreatic cysts are common. For example, up to 15% of the U.S. population will develop a pancreatic cyst at some point in their lives. Most of these cysts are benign, but a small fraction will transform into cancer, including pancreatic NET.

A molecular test developed by the University of Pittsburgh is able to distinguish benign pancreatic cysts from those that can evolve into cancer with reliability close to 90%. The results of the trial that confirmed the validity of the exam were published in the journal Gastroenterology. “Pancreatic cysts can be roughly classified as non-mucinous, which are benign, and mucinous, which have the potential to give rise to a form of pancreatic cancer,” the researchers explain in a statement.

A molecular test called PancreaSeq accurately classifies pancreatic cysts as potentially cancerous or benign, according to a large, multi-center study led by the University of Pittsburgh School of Medicine and UPMC researchers. Published in Gastroenterology, the prospective study of more than 1,800 patients found that incorporating molecular markers improved the accuracy of diagnoses compared with current guidelines based on imaging of cysts.

The test also performed well in detecting non-mucinous cysts and another type of lesion called pancreatic neuroendocrine tumors. Also known as PanNETs or pNETs.  The sponsor said this study lays the foundation for developing prognostic biosignatures for PanNETs so that they identify which tumors will metastasize and which won’t.

Current guidelines for assessing whether a pancreatic cyst is cancerous mostly rely on imaging features such as size and growth rate. The researchers found that PancreaSeq distinguished different types of cysts with higher accuracy than traditional forms of surveillance and current pancreatic cyst guidelines.

An expanded version of PancreaSeq that includes a broader array of biomarkers is now available to patients both within the U.S. and internationally. Samples are collected at local centers and are sent to UPMC for testing and analysis. The researchers are now applying for broad insurance coverage, which they hope to have approved by the end of the year.