Pancreatic cancer is one of the deadliest, hardest-to-treat cancers because most cases aren’t discovered until late stages, after the cancer has spread, when it’s challenging to treat. Only about 13% of people diagnosed with the disease live five years or more after diagnosis, according to the American Cancer Society’s Cancer Facts & Figures 2026 report.
But now, a major new study shows that a blood test developed by researchers led by City of Hope® Cancer Center, a national leader in pancreatic cancer research, could detect the disease much earlier, when it’s not only more treatable but also potentially curable.
The large, international study found that the new, investigational liquid biopsy called Panxeon (short for pancreatic cancer exosome) is highly effective in detecting Stage 1 and 2 pancreatic cancer (finding 87%) and had a low rate of false positives, according to the study published in the journal Nature Medicine.
The test was also able to identify high-grade dysplasia, a precancerous condition of the pancreas, potentially allowing patients to be treated even before cancer develops.
“Pancreatic cancer remains so deadly largely because we find it after the window for cure has begun to close,” said senior author Ajay Goel, Ph.D., AGAF, a gastrointestinal cancer researcher and chair of the Department of Molecular Diagnostics and Experimental Therapeutics at City of Hope Cancer Center Duarte. “For patients, these findings represent progress toward finding pancreatic cancer before symptoms appear and while more treatment options remain available.”
This article explains how the new test works and covers the basics on pancreatic cancer, including:
- Why pancreatic cancer survival rates are low
- How is pancreatic cancer diagnosed?
- How does a liquid biopsy like Panxeon work?
- How is pancreatic cancer treated?
- What advances are being made?
If you or a loved one is concerned about possible signs or symptoms of cancer and would like an initial consultation or a second opinion, call us 24/7 at 877-460-4673.
Why Pancreatic Cancer Survival Rates Are Low
Pancreatic cancer has the lowest survival rates of any cancer, with just 13 of every 100 patients diagnosed living five years or longer. That’s because some 90% of patients are diagnosed with pancreatic cancer in advanced stages, only after their tumors have spread to other parts of the body, when the disease is harder to treat.
One reason for pancreatic cancer’s low survival rate is that early symptoms are often vague or easy to miss. Symptoms like fatigue or digestive issues, for instance, are easily mistaken for other common health issues, so many people aren’t diagnosed until the cancer has progressed to the point that surgery and other treatments are no longer options.
What’s more, there’s also no routine screening test for pancreatic cancer — unlike breast, prostate and colorectal cancer for which screening may lead to early detection.
In addition, pancreatic tumors are complex and tend to form a dense layer of tissue that makes it harder for treatments like chemotherapy or immunotherapy to reach cancer cells. The cancer also tends to spread early, even when tumors are small, making it difficult to detect, catch and combat.
How is Pancreatic Cancer Diagnosed?
Doctors use various tests to diagnose and stage pancreatic cancer. These may include imaging tests — such as ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) scans — that provide a look inside the body. Other tests include those listed below.
Cholangiopancreatography: This procedure examines pancreatic bile ducts to determine if a tumor is blocking a duct.
Endoscopic retrograde cholangiopancreatography: This test involves an upper gastrointestinal endoscopy and X-rays to examine the pancreatic ducts and bile.
Percutaneous transhepatic cholangiography: This less common procedure involves inserting a needle through the abdomen and into the bile duct and injecting a contrast dye, allowing doctors to obtain clear X-ray images.
Biopsy: Doctors may retrieve a tissue sample through a fine needle aspiration, in which a small, hollow needle is inserted through the skin and a small sample of tissue is removed, or endoscopically, where a doctor passes a thin tube with a camera at the end down the throat to remove a tissue sample.
Surgery: Laparoscopic surgery may be used to look for disease within the organs, typically to look for tumors that have spread beyond the pancreas.
How Does a Liquid Biopsy Like Panxeon Work?
Blood tests may be used to help diagnose pancreatic cancer and to check a patient’s health, including: tumor marker testing (a blood test that measures small amounts of genetic material, released by cancer tumors); liver functionality testing that helps doctors look for jaundice, an early sign of pancreatic cancer; and a complete blood count (CBC) that may be used to gauge a patient’s general health before deciding on treatment options.
Panxeon is a new type of test, known as a liquid biopsy — a blood test that detects cancer by analyzing circulating tumor cells or tiny fragments of DNA that tumors shed into the bloodstream.
It works by testing a blood sample for not just one but three markers of pancreatic cancer: circulating microRNAs, exosomal microRNAs and a protein called CA19-9. The test then uses artificial intelligence (AI) to combine all three measurements into a single score that estimates a patient’s risk.
It’s the first investigational test to combine these three biomarkers into a single test.
For the new study of Panxeon, published in Nature Medicine, researchers tested it in nearly 1,800 patients across the United States, Europe and Asia to determine if early promising results would hold up in more diverse clinical settings.
According to the researchers, the blood test correctly identified Stage 1 and 2 pancreatic cancer 87% of the time, while its false-positive rate was just 3% in low-risk groups and 16% in high-risk groups. Rather than replacing imaging or other diagnostic tests, Panxeon may help identify high-risk patients who should undergo further evaluation, Dr. Goel said.
The liquid biopsy also detected high-grade dysplasia, an advanced precancerous condition that’s often considered “Stage 0” pancreatic cancer, more than 64% of the time. This finding may help physicians better identify which pancreatic cysts require active monitoring or intervention before invasive cancer develops.
Early detection has been a major research goal for years, but previous blood-based tests have fallen short. According to Dr. Goel, combining multiple biomarkers into a single test and then evaluating it in people with familial or inherited genetic risk, pancreatic cysts and chronic pancreatitis, rather than only healthy controls, is what sets Panxeon apart.
“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,” he said.
Patients most likely to benefit include those with inherited risk, a family history of pancreatic cancer, pancreatic cysts or chronic pancreatitis. These individuals are often monitored through imaging and other tests, but current approaches are invasive, expensive and only somewhat helpful at detecting cancer at the earliest stages. A reliable blood test could help identify who needs further evaluation.
“A stage shift isn’t just a statistic,” Dr. Goel said. “The earlier we find pancreatic cancer, the greater the chance that meaningful intervention is still possible.”
How is Pancreatic Cancer Treated?
Pancreatic cancer is principally treated through surgery, ablation, embolization, chemotherapy, radiation therapy and some forms of targeted therapy — which are more effective when used early in a cancer’s development — as listed below.
Surgery: There are several forms of pancreatic cancer surgery, including the Whipple procedure (which involves removing the “head” of the pancreas and other tissues); distal pancreatectomy (in which the bottom half, or “tail” of the pancreas, is removed; total pancreatectomy (removal of the entire pancreas); and laparoscopic and robotic surgery.
Ablation: This procedure destroys tumor cells by using extreme heat, cold, microwaves or electrical currents to eradicate tumor cells.
Embolization: This treatment shrinks tumors by blocking their supporting blood vessels, which may be accomplished with particles, chemotherapy drugs or radioactive beads injected into the artery feeding the tumors.
Chemotherapy: Drugs may be given before an operation to try and shrink the tumors — increasing chances of surgical success — or following surgery to kill stray cancer cells and prevent a recurrence. It’s also used when tumors may not be removed surgically. Chemotherapy may also be given in combination with radiation therapy to enhance the cancer-fighting effectiveness of both — known as chemoradiation therapy. For patients who are healthy enough, a combination of several chemotherapy drugs may be administered for maximum effectiveness. However, patients who are too weak to tolerate combination treatments may be given a single drug. Chemotherapy is often administered in cycles, with rest periods in between to allow the body to recover.
Radiation therapy: This treatment uses external beams focused on the tumor and may be given before surgery, often in combination with chemotherapy, to shrink tumors and help optimize surgery. When surgery isn’t feasible, radiation therapy may also be used to relieve pain and other symptoms.
Targeted therapy: This treatment uses specialized drugs that work differently than standard chemotherapy by targeting cancer-specific cells and processes.
What Advances Are Being Made in Pancreatic Cancer?
Even though pancreatic cancer survival rates remain low, they’ve tripled in recent decades, reflecting progress in early detection, treatment and supportive care. Areas of progress in diagnosing and treating pancreatic cancer include those listed below.
Earlier detection research: Using new tools, including blood-based tests like Panxeon, researchers are pushing to find pancreatic cancer earlier, when treatment is more effective.
More personalized treatments: By analyzing a tumor’s genetic makeup, doctors are able to match patients to therapies — including newer drugs that target specific mutations.
Growing role of AI and data: AI and advanced data analysis are speeding research by identifying patterns in scans, medical records and tumor biology to help researchers design smarter studies and explore new treatment combinations more quickly.
Stronger research and patient support: Organizations like PanCAN are also playing a key role by funding research, connecting patients to clinical trials and expert care and advocating for greater investment.
If you or a loved one is concerned about possible signs or symptoms of cancer and would like an initial consultation or a second opinion, call us 24/7 at 877-460-4673.