Pancreatic cancer is relatively uncommon compared with cancers such as breast, prostate, lung, and colorectal cancer, but it has a disproportionately high death rate.
In the United States, estimates suggest around 67,530 people will be diagnosed with pancreatic cancer in 2026, while about 52,740 will die from the disease. Although pancreatic cancer accounts for only about 3% of all cancers in the country, it causes around 8% of cancer deaths, reflecting how difficult the disease can be to detect and treat.
Notably, it can be difficult to detect pancreatic cancer, with most cases diagnosed after it has spread. Data show a 5-year relative survival of about 44% when the cancer is still localized, compared with just 3% when it has spread to distant parts of the body.
Now, a new blood test combining three biological markers may help detect pancreatic cancer at earlier stages, when it is more likely to be treatable.
The large international study, published in Nature Medicine, also shows that the investigational test, called PANXEON, could identify high-grade dysplasia in people with high risk pancreatic cysts. As such, it could potentially enable doctors to identify people who need closer monitoring or further testing before invasive pancreatic cancer develops.
The international study included nearly 1,800 people across the United States, Europe, and Asia. The investigational liquid biopsy, known as PANXEON, correctly identified stage 1 and stage 2 pancreatic cancers 87% of the time.
The test’s false-positive rate varied according to a person’s underlying risk of pancreatic cancer. It was about 3% among people considered low risk and 16% among those at higher risk.
Previous blood-based approaches to pancreatic cancer detection have faced challenges with sensitivity or specificity. Therefore, the researchers tested PANXEON in people with different levels of pancreatic cancer risk rather than comparing people with cancer only against healthy individuals.
Additionally, rather than relying on a single biomarker, PANXEON combines three biological signals associated with pancreatic cancer:
An artificial intelligence (AI)-based system combines these measurements into a single score estimating a person’s likelihood of having pancreatic cancer. The researchers suggest that combining these biomarkers may provide a more complete picture of biological changes occurring in the pancreas than relying on any one marker alone.
“The most significant finding is that PANXEON was able to detect a high proportion of stage I and stage II pancreatic cancers, which are the stages at which treatment is most likely to be potentially curative,” study senior author Ajay Goel, PhD, AGAF, chair of the Department of Molecular Diagnostics and Experimental Therapeutics at City of Hope, explained to Medical News Today.
“Just as importantly, the test was evaluated across a large international, multicenter population and in people with clinically relevant pancreatic conditions, not simply by comparing cancer patients with healthy individuals.”
“What makes this study encouraging is the possibility that a simple blood test could eventually help identify pancreatic cancer before symptoms develop and before the disease has spread. That is the window in which we have the greatest opportunity to change outcomes.”
– Ajay Goel, PhD, AGAF
A notable finding from the study was PANXEON’s ability to detect high-grade dysplasia, an advanced precancerous change in the pancreas. Among people with high-risk pancreatic cysts, the test identified high-grade dysplasia more than 64% of the time.
High-grade dysplasia can occur in pancreatic cysts and can be considered a warning sign that invasive cancer may develop. Identifying people with higher-risk lesions could therefore give clinicians an opportunity to monitor or treat them before cancer becomes invasive.
“This is perhaps one of the most exciting findings in the study,” Goel noted to MNT. “High-grade dysplasia represents an advanced precancerous change that has not yet become invasive pancreatic cancer, so identifying it creates the possibility of cancer interception rather than simply earlier cancer diagnosis.”
“If these findings are confirmed in larger prospective studies, a blood test could potentially help physicians identify which pancreatic cysts are becoming biologically dangerous and which can continue to be monitored. In principle, intervening at the stage of high-grade dysplasia could prevent some pancreatic cancers from ever becoming invasive, although our current data are still too early to prove that clinical benefit.”
However, while the results are promising, they do not mean that PANXEON can currently predict with certainty which individual pancreatic cysts will become cancerous. Further research will be necessary to determine how the test performs in routine clinical practice and whether using it actually leads to earlier diagnosis and improved survival.
Additionally, the researchers emphasize that the test is not intended to replace imaging scans or other diagnostic procedures. Instead, they suggest the blood test could potentially be used to identify people who should undergo additional evaluation.
“I see a blood test such as PANXEON becoming an additional layer of information within existing surveillance, rather than replacing MRI or endoscopic ultrasound. A positive or rising molecular signal could help identify which high-risk individuals need earlier imaging, endoscopic evaluation or closer follow-up,” Goel adds.
“Over time, serial blood testing may also allow surveillance to become more personalized. Instead of monitoring every high-risk individual in exactly the same way, we may eventually be able to combine inherited risk, imaging and molecular changes in the blood to determine who needs more intensive evaluation and when. That could make surveillance both more precise and more practical.”
PANXEON may be a particularly useful blood test for people already considered to have an elevated risk of pancreatic cancer. This could include those with:
These groups may already undergo regular imaging or other forms of surveillance. A blood test could potentially provide a less invasive way of identifying people who warrant additional investigation.
“The more immediate and realistic opportunity is among people who are already known to be at increased risk, such as those with a strong family history, inherited cancer-predisposition variants, pancreatic cysts or chronic pancreatitis,” Goel explained. “If future studies establish even greater accuracy and clinical utility, the populations who could benefit may eventually expand, but that will require careful prospective evidence.”
Still, the test remains investigational. The current findings show that PANXEON can identify cancer and precancerous changes in a research setting. However, further testing is needed to establish its readiness for routine screening in the general population.
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PANXEON’s combination of multiple biomarkers is intended to detect as many cancers as possible while avoiding large numbers of false-positive results that could lead to unnecessary scans, procedures, anxiety, or other potential harms.
The next step will be determining whether the test’s performance can be reproduced in additional populations and whether incorporating it into pancreatic cancer surveillance ultimately improves patient outcomes.
For now, the findings offer evidence that a blood-based, multi-biomarker approach could become part of future strategies for detecting pancreatic cancer earlier, potentially even before invasive disease develops.
“The larger goal is not simply to diagnose pancreatic cancer a little earlier. It is to find the disease at a point when we can still change its course, and ideally to identify dangerous precancerous changes before invasive cancer develops,” Goel concluded.
