Plasma vascular endothelial growth factor levels are a potential therapy-response biomarker for pancreatic cancer

Introduction: Cytokines have long been studied for their role in the pathophysiology of cancer, though their role is varied and complex. Cytokines have been mainly developed as a diagnostic or prognostic biomarker using a single measurement from a cohort of patients. Dynamic changes in cytokines may inform us about the prognostic impact of therapy under investigation. Methods: We investigated retrospectively whether a panel of selected cytokines could be used as a potential biomarker to assess treatment response and predict the prognosis of pancreatic ductal adenocarcinoma (PDAC) patients (n=19) treated with combination of Gemcitabine, nab-Paclitaxel and all-trans-retinoic acid (ATRA), in the Phase I trial (STARPAC, NCT03307148). We measured cytokine levels in the plasma samples, from multiple cycle/visit time-points. Results: Of the six cytokines (IFN-γ, IL-8, IL-16, VEGF, IL-1RA and RANTES) assessed from the STARPAC trial, we propose that VEGF could serve as a potential biomarker for eventual therapy response, as early as the second chemotherapy cycle (of six). Discussion: VEGF as a potential therapy response biomarker will need to be tested in phase II randomized controlled trial.