Development and validation of a diagnostic prediction model for pancreatic ductal adenocarcinoma: VAPOR 1, protocol for a prospective multicentre case-control study.

Journal: BMJ open
Published Date: Aug 27, 2025

Abstract

INTRODUCTION: Pancreatic ductal adenocarcinoma (PDAC) continues to have extremely poor patient outcomes, unlike other cancer types which have seen significant improvements in their treatments and survival. A major contributing factor is that PDAC is often detected at an advanced, incurable stage. In the UK, nearly half of patients have stage 4 disease at the time of diagnosis, which has a profound effect on treatment options and, ultimately, survival. To address the challenge of early detection of PDAC, this study aims to develop and validate a clinical prediction model based on a non-invasive breath test. The proposed breath test aims to assist general practitioners in the triaging of patients who present with symptoms that do not meet current criteria for urgent suspected PDAC pathway referral.

Authors

  • Caoimhe M Walsh
    Department of Surgery and Cancer, Imperial College London, United Kingdom.
  • James Murray
    Human Performance Research Centre, School of Sport, Exercise and Rehabilitation, Faculty of Health, University of Technology Sydney (UTS), Moore Park, Sydney, NSW, Australia.
  • Ivan Laponogov
    Computational and Systems Medicine, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
  • Aaron Parker
    Department of Surgery and Cancer, Hammersmith Hospital Campus, Imperial College London, Du Cane Road, London, W12 0NN, UK.
  • James K Ellis
    Department of Surgery and Cancer, Hammersmith Hospital Campus, Imperial College London, Du Cane Road, London, W12 0NN, UK.
  • Valerio Converso
    Department of Surgery and Cancer, Hammersmith Hospital Campus, Imperial College London, Du Cane Road, London, W12 0NN, UK.
  • Emma Austin
    Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
  • Piers R Boshier
    Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
  • Charles Czajkowski
    Patient and Public Involvement Representative, Pancreatic Cancer UK, London, UK.
  • Duncan Spalding
    Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
  • Ahmed Al-Mukhtar
    Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
  • Adam E Frampton
    Department of Clinical and Experimental Medicine, University of Surrey, Guildford, UK.
  • Keith J Roberts
    University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Sanjay Pandanaboyana
    Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
  • Chris Halloran
    Institute of Systems, Molecular and Integrative Biology, University of Liverpool and Liverpool University Hospitals NHS Foundation Trust, Liverpool, England, UK.
  • Eithne Costello
    Liverpool Experimental Cancer Medicine Centre, University of Liverpool, Liverpool, United Kingdom. Electronic address: ecostell@liverpool.ac.uk.
  • Hemant Kocher
    Barts Health NHS Trust, London, UK.
  • Vikramjit Mitra
    North Tees and Hartlepool NHS Foundation Trust, Hartlepool, UK.
  • Zaed Hamady
    University Hospital Southampton NHS Foundation Trust, Southampton, UK.
  • Bilal Al-Sarireh
    Department of Surgery, Morriston Hospital, Swansea, UK.
  • Samir Pathak
    Centre for Surgical Research, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
  • William Kyle Mitchell
    Dorset County Hospital NHS Foundation Trust, Dorchester, UK.
  • Ajith Kumar Siriwardena
    Manchester University NHS Foundation Trust, Manchester, UK.
  • Claire Westlake
    University Hospitals Plymouth NHS Trust, Plymouth, UK.
  • Stephen P Pereira
    UCL Institute for Liver and Digestive Health, University College London, London, UK.
  • Ioannis Spiliotis
    Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK.
  • Sujata Biswas
    Buckinghamshire Healthcare NHS Trust, Amersham, UK.
  • Vapor Collaborators
    Imperial College London, London, UK.
  • Patrik Španěl
    Department of Surgery and Cancer, Hammersmith Hospital Campus, Imperial College London, Du Cane Road, London, W12 0NN, UK.
  • Kirill Veselkov
    Computational and Systems Medicine, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
  • Linda D Sharples
    Department of Medical Statistics, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
  • George B Hanna
    Department of Surgery and Cancer, Imperial College London, United Kingdom.

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