Ratio between PLGF and sFLt1 is predictive for neural invasion in patients suffering from pancreatic cancer

A method of determining responsiveness of a PDAC patient to an anti-PlGF therapy, the method comprising the steps of:

• a) determining in a sample from the PDAC patient the expression levels of placental growth factor (PlGF) and soluble Fms-related tyrosine kinase 1 (sFlt1);
• b) calculating a ratio of the expression levels of PlGF and sFlt1, wherein:
• i) the ratio is calculated using the expression level of PlGF in the numerator;
• or
• ii) the ratio is calculated using the expression level of PlGF in the denominator;
• c) determining a deviation of the ratio in b) from a ratio of a reference sample or a predetermined threshold value, wherein:
• in i) the ratio of PlGF expression level to sFlt1 expression level is above the ratio from the reference sample or threshold value;
• or
• in ii) the ratio of sFlt1 expression level to PlGF expression level is below the ratio from the reference sample or threshold value;
• and
• d) administering to the patient an anti-PlGF therapy.

A method of determining whether a PDAC patient will benefit from partial or full tumor resection, the method comprising the steps of:

• a) determining in a sample of the patient the expression level of placental growth factor (PlGF) and soluble Fms-related tyrosine kinase 1 (sFlt1);
• b) calculating a ratio of the expression levels of PlGF and sFlt1, wherein:
• i) the ratio is expressed using the expression level of PlGF in the numerator;
• or
• ii) the ratio is expressed using the expression level of PlGF in the denominator;
• c) determining a deviation of the ratio of the patient sample from a ratio of a reference sample or a predetermined threshold value, wherein:
• in i) the ratio between expression levels of PlGF and sFlt1 is above the reference sample or threshold value;
• or
• in ii) the ratio between expression levels of PlGF and sFlt1 is below the reference sample or threshold value;
• and
• d) administering to the PDAC patient in-hospital supportive care and withholding partial or full tumor resection;
• wherein the PDAC patient is ineligible to receive neoadjuvant or adjuvant therapy.