Urinary metabolite prognostic biomarker panel for pancreatic ductal adenocarcinomas.

Abstract Background Patients with pancreatic ductal adenocarcinoma (PDAC) have a very low survival rate and surgical resection is the only curative intent treatment available. However, the majority of patients relapse after surgery and identification of biomarkers for accurate prognostication of PDAC patients is required. We have recently identified a six biomarker (i.e., trigonelline, glycolate, hippurate, creatine, myoinositol and hydroxyacetone) urinary metabolite panel with very high potential to diagnose PDAC (Int J Cancer 2021;148:1508–18). This study aimed to assess the prognostic ability of these previously identified diagnostic metabolites in the urine of PDAC patients. Methods Metabolite data from 88 PDAC patients was statistically assessed for their prognostic ability. Results A panel of three metabolites (i.e., trigonelline, hippurate and myoinositol) was able to stratify patients with good- or poor-prognosis based on overall survival. The PDAC patients with abnormal levels of 2 or more metabolites in their urine demonstrated significantly lower survival compared to patients with abnormal levels of one or less metabolites. Conclusion These results demonstrate that the selected three metabolite panel could be used to stratify patients based on their prognostic outcomes and if independently validated may lead to the development of a urinary prognostic biomarker test for PDAC. General significance This study highlights the potential of using 1H-nuclear magnetic resonance spectroscopy for the identification of novel metabolites which can prognosticate cancer patients.