Multi-Biomarker Blood Test Shows Promise for Early Pancreatic Cancer Detection

The disease is typically discovered after it has spread, and an estimated 90% of tumors are first detected at advanced stages. Earlier detection could expand treatment options and improve outcomes. A new study in Nature Medicine shows an investigational blood test can detect early-stage pancreatic cancer and identify high-grade dysplasia.

City of Hope (Duarte, CA, USA) led the development of PANXEON, an investigational liquid biopsy that analyzes three complementary biomarkers from a blood sample: circulating microRNAs, exosomal microRNAs, and the protein CA19-9. The assay applies artificial intelligence (AI) to integrate these measurements into a single risk score for pancreatic cancer. It is described as the first investigational test to combine these three biomarkers into one evaluation.

In an international study published in Nature Medicine on September 16, 2026, investigators tested the assay in nearly 1,800 patients across the United States, Europe, and Asia to determine whether previously reported promising results would hold up in diverse clinical settings. The approach emphasized evaluation in people with familial or inherited genetic risk, pancreatic cysts, and chronic pancreatitis rather than only healthy controls. The test is intended to complement, not replace, imaging and other diagnostic procedures by flagging individuals who may warrant further workup.

PANXEON correctly identified stage 1 and 2 pancreatic cancers 87% of the time. The false-positive rate was 3% in low-risk groups and 16% in high-risk groups. Notably, the assay also detected high-grade dysplasia—an advanced precancerous condition often considered “stage 0” pancreatic cancer—more than 64% of the time, which could help clinicians determine which pancreatic cysts require monitoring or intervention before invasive cancer develops. 

Patients most likely to benefit from risk stratification include those with inherited risk, a family history of pancreatic cancer, pancreatic cysts, or chronic pancreatitis. City of Hope stated that PANXEON is investigational and that its use may help identify high-risk patients who should undergo further evaluation. The multi-biomarker, AI-enabled design is presented as a distinguishing feature of the assay’s development and testing.

“Pancreatic cancer remains so deadly largely because we find it after the window for cure has begun to close. For patients, these findings represent progress toward finding pancreatic cancer before symptoms appear and while more treatment options remain available,” said senior author Ajay Goel, Ph.D., AGAF, chair of the Department of Molecular Diagnostics and Experimental Therapeutics at City of Hope.

“Most biomarkers tell you one part of the story. Combining multiple biological signals gives us a clearer picture of what may be happening in the pancreas,” added Goel.

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