A recent study in Nature Medicine describes a multi-parametric profile of a pre-metastatic signature using liver biopsy samples to predict metastatic outcomes in early-stage pancreatic cancer (PaC). The investigators obtained liver biopsy samples during pancreatectomy from patients with localized PaC (n = 49) and without cancerous lesions (n = 19).

The liver samples were analysed by combining imaging techniques with metabolomics and tissue and single-cell transcriptomics. Patients were followed up for a median of 3 years and were classified according to their metastatic status. The researchers identified features in the PaC livers to predict metastatic outcomes and distinguish patients who developed liver or extrahepatic metastasis from disease-free survivors. Those biomarkers included enrichment of neutrophil extracellular traps, T cell lobular infiltration, overexpression of interferon target genes and an increase of CD11B+ natural killer cells, among others.