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Plasma cell-free DNA methylome as early detection and prognostic marker for pancreatic cancer

Budhathoki, S.; Brhane, Y.; Fehringer, G.; Shen, S. Y.; Chadwick, D.; Zuzarte, P. C.; Borgida, A.; De Carvalho, D. D.; Gallinger, S.; Hung, R. J.

2025-05-31 genetic and genomic medicine
10.1101/2025.05.29.25328569 medRxiv
Show abstract

Pancreatic cancer is highly fatal, with limited early detection options. Here, we conducted a study to evaluate the potential use of circulating cell-free DNA methylation for pancreatic cancer early detection and prognosis. Using a highly sensitive enrichment-based sequencing technology, we profiled genome-wide circulating cell-free methylome of 199 pancreatic cancer patients and 205 healthy individuals. We identified a panel of differentially methylated regions in cell-free DNA that distinguished pancreatic cancer cases from controls with high accuracy (test set AUC=0.93, 95%CI=0.88-0.98), notably robust accuracy for early-stage pancreatic cancer (AUC=0.92, 95%CI=0.86-0.98). We also identified a panel of cfDNA methylated regions that effectively stratified patients into longer or shorter survival groups, which was independently validated in The Cancer Genome Atlas cohort (HR=1.37, 95%CI=1.00-1.88, p=0.049). These results provide support for the potential utility of cell-free DNA methylation markers for both early detection and prognosis in pancreatic cancer, presenting a promising tool for enhancing patient management.

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