Researchers at City of Hope have developed an investigational liquid biopsy called PANXEON that demonstrated high sensitivity for detecting pancreatic cancer at stages 1 and 2, when the disease is more likely to be treatable. The findings from a large international study are published in Nature Medicine.
Pancreatic cancer carries the lowest five-year survival rate of any cancer at approximately 14%, largely because around 90% of cases are diagnosed at advanced stages after metastasis has occurred. Early detection has been a longstanding research priority, but previous blood-based tests have shown insufficient accuracy for clinical use.
PANXEON takes a multimarker approach, combining three distinct measurements in a single test: circulating microRNAs, exosomal microRNAs, and the protein CA19-9. An artificial intelligence algorithm integrates these three signals into a unified risk score, making it the first investigational test to combine this combination of biomarkers.
The study tested PANXEON in nearly 1,800 patients across the United States, Europe, and Asia. The test correctly identified stage 1 and 2 pancreatic cancer 87% of the time, with a false-positive rate of 3% in low-risk groups and 16% in high-risk groups. Notably, the test also detected high-grade dysplasia, an advanced precancerous condition sometimes classified as stage 0 pancreatic cancer, in more than 64% of cases, potentially enabling intervention before invasive cancer develops.
The researchers note that PANXEON is intended to complement rather than replace existing imaging and diagnostic procedures. Patients most likely to benefit include those with a family history of pancreatic cancer, inherited genetic risk, pancreatic cysts, or chronic pancreatitis. These groups are currently monitored through approaches that are invasive, costly, and of limited sensitivity at early stages.
Further validation studies are needed before the test can be considered for routine clinical use.
Source: Xu C et al. Liquid biopsy for early detection of pancreatic ductal adenocarcinoma. Nature Medicine (2026). DOI: 10.1038/s41591-026-04625-x
